Journal of Local and Global Health Science - Proceedings of the 24th World International Traffic Medicine Association Congress, Qatar 2015, نوفمبر ٢٠١٥

Worldwide, the injuries caused in traffic accidents constitute a public health problem of great importance. Its strong impact generates a high percentage of deaths, hospital admissions with high costs, material losses, pension costs, and of course too much suffering for the victims and their families. There is need for effective public policy, since traffic accidents in many cases are not actually “accidents” but pretty much predictable occurrences, therefore, preventable. According to the Pan American Health Organization's classification of the mortality rate (scored by country): a low risk rate is below 10 deaths per 100 thousand inhabitants; the medium risk is between 10 to 20 deaths; and high risk is above 20 deaths per 100 thousand inhabitant. Most countries in South America are between medium and high risk. In Brazil, the death rate by road accidents between 2000 and 2010 ranged from 18 to 22.5 deaths per 100 thousand inhabitants. Meaning, it entered the highest statistic. However, the risk of death for pedestrians has reduced. Even though, the drivers of cars and motorcycles presented growth (2). Throughout the Pan American region, it is estimated that annually there are 130,000 deaths, 1.2 million injuries and hundreds of thousands of disabled. In each region there is a significant difference in the victim’s profile, nevertheless around 80% of the fatalities in each country are men of working age, between 30 and 44 years; a general trend for all Americas 3. In poorer countries of the Americas, alcohol appears as the main risk factor for contracting diseases, more than low weight, malnutrition and tobacco. Adding all other countries, alcohol remains first (3). Among men, 13% of mortality is related to alcohol consumption, while among women, this ratio is 3.4%; for the total of both sexes, 8.8%, which means that one in every ten deaths is attributed to alcohol. Accidents due to driving under the influence of alcohol are a serious problem in any country that makes a broad use of motor vehicles. In Brazil, DETRAN - SP’s data states that 50% of traffic accidents are related to alcohol consumption (1). In 2011, the Member States of Pan - American Health Organization approved the Plan of Action on Road Safety, which will help the countries of the region to achieve the decade’s goals of Action Security on Traffic 2011-2020. With the adoption of the proposals, it is expected that five million lives will be spared by 2020. The actions are focused interventions in the priority risk factors of occurrence of traffic accidents, such as: drinking and driving, excessive or inappropriate speed (4). References: 1. Duailibi, Sérgio; Laranjeira, Ronaldo. Políticas Públicas Relacionadas às Bebidas Alcoólicas. Rev. Saúde Pública vol. 41 nº 5 São Paulo, Oct. 2007. http://www.scielo.br/scielo.php?pid=S0034-89102007000500019&script=sci_arttext 2. NETO, Otaliba Libânio de Morais et al. Ciênc. Saúde Coletiva vol.17 nº 9 Rio de Janeiro Sept. 2012. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000900002 3. PAHO – Pan American Health Organization/WHO – Conferência Pan-Americana sobre Segurança no Trânsito, 2005. Brasília. http://www.bvsde.paho.org/bvsacd/cd51/respuestaspt.pdf 4. Portal Da Saúde. Países Assinam Acordo para Reduzir Vítimas de Acidentes de Trânsito. Jun. 2015. http://portalsaude.saude.gov.br/index.php/cidadao/principal/agencia-saude/18048

Introduction/Problem statement In 2007, road safety was assessed as one of the more serious safety risks in Ras Laffan Industrial City (RLIC). It accounted for 1,540 road traffic crashes, one fatality, several serious injuries and a number of property damages during the year. As a result a committee was formed which included all stakeholders in the Industrial City to set achievable and sustainable goals to reduce the road safety risk rate to “As Low as Reasonable Practical” (ALARP). The committee developed and implemented a sustainable road safety program, holding all persons entering RLIC responsible for contributing to a new safety culture. The aim was to reduce road related crashes by at least 20% per annum. Methods 1. The committee conducted an ALARP road safety study to identify and analyze the highest road safety related risks in all common road and concession areas of the Industrial City and established mitigation measures for each risk identified to prevent death, serious injury or property damage. 2. Investigated the root causes of road traffic crashes and classified them in categories that include human behaviour, road engineering, vehicle fitness, driver fitness and environmental conditions such as dust and fog. 3. Developed and implemented sustainable mitigation measures for each of the categories identified. 4. Developed and implemented a road crash database to record and track crash data. Throughout this process focus was given to incident investigation, statistical analysis, end users involvement, awareness campaigns, alternative transport modes, speed enforcement, radar monitoring systems, audits, inspections of road network and systems, community outreach programs, education and enforcement. Results As a result a high-level awareness road safety “Zero Tolerance Visibility Program” was introduced with input from the local traffic department, business partners and industry road safety experts. Between 2007 and 2014, road traffic crashes were reduced by 85% cumulatively. The strategies proved to be successful by: (1) the reduction in fatalities from one fatality in 2007 to zero fatalities during the period of 2008 to 2014; and (2) a notable reduction in road traffic crashes from 1,540 in 2007 to 278 in 2014. Conclusions Overall the Zero Tolerance Visibility Program implemented during 2007 yielded positive results. With continuous improvement of the vision for safer roads, further reductions in road traffic crashes will be achievable. Furthermore, these strategies may also be suitable for application in other workplaces similar to Ras Laffan Industrial areas.

The issue of road traffic safety in mainland China is particularly serious. The total number of vehicles is growing rapidly (e.g. 60 million in 2000 vs. 240 million in 2012); meanwhile the number of road traffic accidents and associated casualties still remains high and shows no signs of meaningful decline. It is reported road traffic causalities in China ranks highest in the world, with an annual death toll exceeding 100,000 and an average daily death toll of 300 [Yue, Liu & Cai, 2004]. Therefore, it is urgent to build up a China-specific road traffic injury treatment network in order to reduce the fatality and disability rate. This article intends to review China’s road traffic injury treatment system from pre- and in-hospital aspects, meanwhile discuss how to improve traffic safety in the future. 1. Pre-hospital rescue system for traffic injury To improve the efficiency of pre-hospital treatment, the key lies in shortening the reaction time, which calls to establish a multi-level treatment system in each region. In China, trauma treatment system is built upon regional emergency centers and 120 emergency calls. The city level rescue systems are generally well-established, comprising of independent emergency centers or emergency departments affiliated with large hospitals. Most of county-level trauma treatment systems rely on county hospitals, while rural areas on first-aid stations [Wang, 2000]. There are three main types of pre-hospital rescue control center in China (Table 1). In addition, standardization of pre-hospital treatment unit, quick on-site rescue and real-time connect with the corresponding medical treatment organization are essential. China’s road injury pre-hospital treatment system varies greatly across regions, mainly resulted from differences in regional cultures, economic development, and status of local infrastructure. These differences have led to issues such as non-standardized pre-hospital treatment system, deficient emergency treatment network, prolonged accident response time; shortage of emergency rescue staff, etc. 2. In-hospital traffic injury treatment There is no universal in-hospital trauma treatment protocol in China. Majority of the general hospitals use specialist consultation to treat trauma patients. The two dominant mechanisms are cross-department consultation coupled with serial treatment process and integrated process. In our hospital, trauma treatment center consists of specialists and technicians from many departments such as general surgery, orthopedics, neurosurgery, etc. Conclusion Improving traffic injury treatment requires a systematic approach and coordinated efforts from the whole society. After all, the medical emergency treatment is the last link of the 5E strategy (education, environment, enforcement, engineering, and emergency). To conduct definitive treatment in the golden window and to enhance the pre-hospital as well as in-hospital treatment capabilities are critical. It is also recommended to unify various pre-hospital and in-hospital treatment protocols in China based on field experience [Wang 2007]. Other critical areas include to establish a national level treatment system closely linked to the 120 emergency call system, to use helicopters as the main aerial transport vehicles, to set up state-level training centers for trauma treatment, to build national and regional traffic injury database, and to formulate standards to qualify trauma treatment hospitals and doctors References Yue MX, Liu ZG, Cai XQ, et al (2004). The characteristics of road traffic injuries and a new concept for on-site emergency rescue. Chinese General Practice, 7, 1803-1805. Wang YT (2000). Current status and future prospects for China’s pre-hospital rescue of traffic injury. Journal of Traumatic Surgery, 2, 5-6. Wang ZG (2007). Research and reflections on road traffic injury. Acta Academiae Medicinae Sinicae, 29, 455-458.

تشكّل الحوادث المروية بدرجة كبيرة قلقًا كبيرًا، وهاجسًا مؤرقًا ومؤلمًا لأفراد المجتمع كافة..؛ وأضحت من أهم المشكلات التي تستنزف الموارد الحيوية، والمادية والطاقات البشرية خاصة الشابة منها، فضلاً عمّا تكبّده من مشكلات اجتماعية ونفسية وخسائر مادية ضخمة؛ ما يدعونا جميعًا إلى إيجاد الحلول والاقتراحات ووضعها حيز التنفيذ للحد منها؛ وتقدير معالجة أسبابها والتخفيف من وطأة آثارها السلبية. والواقع يذكّرنا دومًا، أنه بالرغم من تنظيم، العديد منحملات التوعية؛ وإقامة المزيد من الفعاليات التي قدّمت لمجتمعاتنا العربية، على مدار العقود الماضية؛ وبالرغم من تقدير الجهد الرسمي المبذول: ماديًا ومعنويًا في سبيل التوعية المرورية لحماية الإنسان، أغلى ما تملكه الأوطان، وحفاظًا على أمنها وسلامتها إلا أن هذا الواقع، كان شاهدًا على تواضع نتائجها، التي لم ترتق إلى تطلعات المراقبين والمهتمين؛ ولم تحقّق المرجوّ منها؛ لافتقادها إلى سياسات واستراتيجيات وبرامج فاعلة، وصولاً للمعالجات الناجعة في هذا الخصوص. ورغم انفراد إدارات المرور بهذه الجهود المبذولة والتي تعد خارج اختصاصاتها بالأساس؛ إذ المهمة الأساسية لرجال المرور، تنفيذ الأنظمة واللوائح لانضباط الشارع، ومن بينها تعقب مخالفات السير ورفع الحوادث ومعالجات القصور فيهما؛ انطلاقًا من مسؤوليتهاالإدارية والفنية والتوعوية، في هذا الخصوص، إلا أن هناك شعورًا عامًا، ما زال عدم مساندة مؤسّسات التنشئة الاجتماعية الرسمية والأهلية الأخرى، التي لم توفق في إيصال هذه الرسالة السامية لأفراد المجتمع وشرائحها كافةً. وبالرغم من تكرار الأنظمة والقوانين والتوصيات، الرسمية وغيرها من قرارات أصحاب السمو والمعالي وزراء الداخلية بدول مجلس التعاون، وتوصيات المختصين في الفعاليات والمؤتمرات المرورية كافةً، إلا أن هذه الأنظمة والقوانين والقرارات والتوصيات لم تجد سبيلاً للتطبيق الميداني المنشود لمجتمعاتنا من خلال: 1. إيجاد برامج منهجية وإلزامية للسلامة المرورية للأجيال المقبلة. 2. المشاركة المجتمعية الفاعلة من خلال جمعيات للحد من الحوادث المرورية. 3. توافر برامج لإعادة تأهيل قائدي السيارات مسببوا الحوادث على أسس علمية، ونفسية واجتماعية وطبية وعلمية. يحاول هذا البحث في إيجاز إلقاء الأضواء على النقاط أعلاه، التي أرى أنها لم تنل القدر الكافي من الاهتمام في هذا الخصوص خليجيًا وعربيًا.

Provoking the loss of a productive workforce and the waste of economic resources, through death or disability, the social and economic ramifications of road accidents attract the attention of researchers and stakeholders alike. Accidents have detrimental social, health and psychological consequences for families and cause them financial burdens. One of the means of protection against road accidents lies in taking preventive safety measures and educating children about them in order to reduce the risk of exposing children to accidents in the Kingdom of Saudi Arabia. Excluding non-communicable diseases, road accidents are the leading cause of death in the Kingdom. The safety belt in the vehicle is the first means of safety while driving. The 1998 Saudi Law on the use of safety belts defines the device as that part which holds the user's body firmly on the seat. On account of the exponential increase in the rate of road accidents and casualties, the need for the use of seatbelts cannot be overemphasized. This does not exclusively concern adults but also children who should be provided with the necessary means of protection and safety.

We all learn how to protect our children at home, prevent them from playing with fire and sharp and harmful objects; we cover electric plugs and keep electric appliances away from them, and moderate the temperature of the heater in order to protect our children from being burned. We also learn the basics of first aid to rescue our children in case they are exposed to danger. However, have we ever thought of protecting our children when they are outdoors? Have we ever taught them how to cross the road and how important it is to use the safety belt in the car? Do we actually use it ourselves? Do we use the safety child seat for our children from birth? Have we ever shown them the importance of the car seat? The answer to all these questions is mostly in the negative. In our hectic daily life, and in our desire to reach places quickly, we forget or ignore the importance of safety in the car, and also forget or pretend to have forgotten the basic Islamic principle which urges Muslims to be cautious and, after entrusting our fate to Allah, to make use of all means. Prophet Mohammed (PBUH) said: “Trust in Allah but tether your camel.” The Holy Koran forbids exposing oneself to harm. Allah, the Almighty, says: “and make not your own hands contribute to (your) destruction.”

This paper examines the importance of the child car seat and its role in safeguarding children. Some of the relevant issues this paper intends to raise include: What are the best types of children's car seats and seatbelts? How should safety seats be used? Can a child use a seatbelt and dispense with the safety seat? What happens when the child safety seat is not available in the vehicle? In addition to other relevant issues, this paper discusses the psychological impact of traffic accidents and the importance of reckoning with the Islamic principle of making use of all.

Traffic safety is one of the most important means to protect human life as well as personal and public property from harm and to contribute to social and economic growth and development. Several factors have been linked to traffic safety, but the most prominent ones are: the driver, the vehicle and the road. This paper, however, focusses only on the driver as an essential factor that impacts others, and analyzes the driver’s behavior and how drug use and psychoactive substances relate to road accidents and traffic safety. On the one hand, official statistics in the Kingdom of Saudi Arabia reveal that up to 2014, traffic accidents had increased by %400 in the previous ten years, and in the past 23 years more than half a million people were injured and sixty thousand died. This represents an annual average of 4200 deaths, 1200 permanent disabilities and 8000 temporary disabilities. On the other hand, official statistics in the Kingdom of Saudi Arabia point out to a-ten-fold increase in the previous years in the use of drugs and psychoactive substances.

In 1980, drug cases were in the range of three thousand, but today there are more than 40,000 annually, %70 of which concern drug consumption. Since traffic safety requires that drivers observe a high degree of vigilance and caution in order to cope with road conditions, scientific studies indicate that drivers under the effect of narcotics and psychoactive substances lose the ability to deal with unexpected emergencies. They lose the ability to concentrate and they suffer from disequilibrium in perceiving road turns and intersections and slow eye response to light, among other factors. Owing to the fact that traffic safety is vital in safeguarding society, human life and economic resources, it is essential to study the relationship between traffic accidents and the driver's behavior under the effect of narcotics and psychoactive substances. This relationship should be examined in a profound and scientific way to enable us to take appropriate decisions and offer practical solutions and to ensure road safety. This paper addresses three issues: the size and type of traffic accidents in relation to the driver’s behavior, the size and type of traffic accidents related to the behavior of the driver under the influence of narcotics and psychoactive substances, and the practical solutions for these problems with a view to achieving the right to traffic safety for all.

People are the most important asset of any nation, and general safety is one of its most important requirements. Traffic safety, which is one of the components of the general safety of any modern nation, consists of four essential elements: the road network, the human factor, the vehicle and the traffic police and laws. In implementing the principles of the safety of modern roads and in devising plans for their projects, engineers, decision makers and executive authorities in the state should make of the protection of human life their priority. Preliminary studies concerning the number of road accidents in the Kingdom of Bahrain from 2010 to 2013 reveal that among the pedestrian casualties %27 were children and young people.

This study aims at designing safe roads for children and young pedestrians through the development of road networks in the areas where these age groups live (schools, residential areas and public places). The solutions I put forward are based on engineering designs intended for pedestrian protection.

To achieve this goal, a pilot study was conducted on traffic accidents and the number of casualties by collecting data from the Ministry of Interior and the General Directorate of Traffic for the period 2013-2010. The focus was on the age group 19-0 years, the gender of the victim, the level of danger, the timing of the accident and the date of the accident with a view to developing a clear picture of the causes of road accidents and their relationship with the design of the road.

In order to obtain clear results, the descriptive statistical methods analysis was used to determine the size of the problem and the need for safe roads. For this purpose, two questionnaires were designed: the first for young road users aged 19-4 years, and the other for parents/guardians aged 19 years and above.

The results of the study revealed that the proportion of male victims tended to be higher than that of females. This may be due to the fact that females are more conscientious and disciplined on the road than male road users and that child pedestrians aged 11-6 years are the age group most vulnerable to road accidents (deaths and injuries). This high accident rate among children reflects the fact that they spend more time outdoors playing or going to school, in addition to their being inexperienced, insufficiently schooled and unable to accurately control their behavior while walking or crossing the road.

The results of the data analysis show that the rate of accidents during the week and on weekends was close, with an average rate of 28.95 accidents during the week and an average of 26.5 cases per day on the weekend. Most of these accidents occurred at 13:00 during the official workdays and between 16:00 and 17:00 on weekends. The results of the questionnaire show that %39 of parents/guardians agree that the current road network in Bahrain is not well designed for pedestrians with %17 of them strongly approving so. However, %33 of parents/guardians agree that the recklessness of drivers makes them worried about letting their children walk to school, while %55 of them strongly agreed about the previous survey question.

The propositions put offered in the questionnaire to improve road conditions, especially elevated pedestrian crosswalks and sidewalk indicators, to set up mobile barriers at the main school gates and to ensure the presence of more than one police officer in front of schools received a high approval rate among students and parents/guardians.

It became clear from the questionnaire results on the opinions of parents/guardians and children that the Kingdom of Bahrain is in dire need of a much safer environment for pedestrians, and based on my engineering background I proposed some practical solutions suitable for the local environment.

Traffic accidents have conventionally been considered as the outcome of a dialectical interplay of three elements: the driver, the vehicle and the infrastructure. Everything that relates to the road, its maintenance and the traffic signs are constituents of the infrastructure. Therefore, all traffic accidents could be interpreted as a flaw in one or all of these elements. By developing new methods, the team I supervise has contributed significantly to the policy of traffic safety on French roads. As part our contribution, we have elaborated a fourth element called “organization,” and now the new paradigm is: the driver, the vehicle, the infrastructure and the organization). This model is today adopted by the majority of French experts.

The fact that the vehicles and the roads are in good condition does not benefit those countries in which the element of «organization» is weak or dysfunctional. The adverse effect comes from the fact that when the driver finds ideal conditions—an excellent road and car—he mostly tends to drive very fast as he does not sense any danger. As a result, ideal road conditions become more conducive for dangerous road accidents than the bad conditions. Our contribution lies in activating the theory that explains this blatant human contradiction. This theory is called the “risk balance theory.” It is as if the driver himself determines a given risk level in his life, so that each time his perception of the risk decreases he changes his behavior and the risk level increases, and vice versa. This theory is valid in most areas in which the human factor is involved. Psychologists consider that the success of the policy of deterrence in achieving traffic safety is attributed to the ticketing process, as offending drivers feel the threat which affects their license, i.e. the level of fear of losing the license increases which, in return, makes the driver refrain from violating the law. Therefore, the policies based on the point deduction system succeed more than the financial sanctions.

The history of traffic safety in France has witnessed two important periods. The first occurred after 1972 when the number of victims reached 18000 dead and 386000 injured. The authorities then set up the Comité Interministériel de Sécurité Routière (Interministerial Committee for Road Safety) under the supervision of the Prime Minister. All ministries were represented on the committee and the binding resolutions were implemented by all the ministers within their respective mandates. This organizational mechanism led, in addition to several other factors, to a significant decline in the number of casualties (3000 lives were saved in two years). This organizational mechanism continues up to now, and the Prime Minister periodically oversees the meetings of the committee which outlines the national traffic safety policy.

The number of casualties of road accidents continues to decline in France over the years but to a limited extent (200 to 300 lives saved annually), as the number of victims reached between 2000 and 8000 dead and 150000 injured. Despite this positive development, the European Commission intervened, considering these figures below expectations given the level of development among the member states and the fact that the mortality rate is an indicator of the progress of countries.

The European Commission set for each member state a goal to be attained within a period of 10 years. For France, the fatality rate should be lower than 3000 before 2012. Therefore, we consider the second crucial phase in the history of French traffic safety to be the one which took place after 2002.

To meet the objectives of the European Commission, France tightened control, activated the organizational mechanism and gave more importance to specialists in human behavior. For example, more than 4500 radars were installed and more than 1500 facilitators, half of whom were psychologists, were trained in awareness programs for traffic offenders. In addition, more than 700 doctors were given supplementary training. The driver’s license point system, particularly its information system part, was restructured, a driver’s license for beginners was initiated and the serious offenders or those who lost all of their points were required to visit psychologists and doctors specifically trained for this purpose.

All of these procedures have made France the closest among European countries to the goal set by the European Commission. The number of fatalities fell from 8150 in 2000 to 3260 in 2012. This achievement did not make France the best European country in traffic safety, but it made it the most successful in improving its statistics. This success story is based on the harmonization of the policies of deterrence and pedagogy and the crucial place given to psychological intervention.

Inspired by my personal contribution, as well as that of all the staff under my supervision, in achieving these satisfactory results, through studies, consultancies, training facilitators and sessions about awareness for traffic offenders, I will seek to demonstrate statistically the distinctive features of the successful French experience and the extent to which this policy is appropriate and applicable to fast developing countries.

• It should be noted that traffic awareness started in Bahrain almost fifty years ago. In 1967, the General Directorate of Traffic launched an awareness campaign to inform drivers that on Friday 27 November 1967 the traffic system would change from left to right. Accordingly, some awareness support programs were launched to activate the traffic change from left to right. Many entities directly or indirectly involved in the traffic field participated, and the objective to change the traffic direction was successfully achieved. It should be pointed out that in the two weeks following the implementation of the change no serious road accident was recorded in Bahrain. • Traffic awareness started as early as 1914 with the introduction of the car in Bahrain. Traffic awareness as such was initiated particularly by mothers who used to instruct their children to cross in the opposite direction of the traffic close to the buildings’ walls. They were instructed not to cross in case a car was on the road close by until it stopped for them to cross. As a result, the concept of traffic awareness was developed along with the adage “haste makes waste.” • One of the effective programs which had an impact on traffic safety was the setting up of an awareness committee for students whose members were all education directors and public relations officers at the General Directorate of Traffic. They met whenever the Directorate thought there was a traffic issue related to students’ safety awareness. The students proposed traffic projects for their own safety. • Some of the indicators of the presence of awareness-raising programs include the successful Traffic Weeks with the participation of all students in the celebrations of the Road Safety Week since 1973 and the Gulf Traffic Week from 1983 onwards. In addition, students participated in all the traffic awareness activities of the General Directorate of Traffic concerned with the traffic direction change from left to right, the establishment of the traffic kindergarten in 1980 and the safe use of bicycles in 1984, among other successful projects in collaboration with the General Directorate of Traffic and the Ministry of Education. • One of the traffic projects adopted by the Schools Traffic Awareness Committee and which had a direct impact on the safety of students was the safe transportation project. Before it was launched, students suffered from several bus incidents. The campaign was founded on essential principles and students were, accordingly, instructed to wait on the pavement, board the bus using the rear seats first and leave the bus after it came to a full stop, get off the bus onto the pavement at the bus stop, observe order in getting off the bus, and if crossing the road, do so from the backside of the bus, not from the front, and only after ensuring there were no speeding vehicles on the road. • Among the short and long-term programs was the project on the transportation and traffic experience, which was put forward in 2006 to deal with the safety of kindergartenage children (6-3 years) and serve as a system to educate children about traffic. • One of the targeted strategies of the General Directorate of Traffic is to initiate children into the traffic system from kindergarten onwards, and each stage should have a book taught in the schools from one stage to another up to high school.

References 1. Radio program “The Road to Safety” (Ministry of Information, Kingdom of Bahrain). 2. “The Safety Path” (Kingdom of Bahrain TV, Ministry of Information). 3. Glimpses of the History of Traffic in Bahrain from 1914 to 1996 (Arab Printing and Publishing Press, Kingdom of Bahrain, 1998). 4. Traffic Projects – The Traffic Kindergarten (1980). 5. Safe Crossing (1990). 6. The Safe Use of Bicycles (Awareness Schools Committee, Ministry of Education, 1984). 7. Safe Transportation – General Directorate of Traffic (1995). 8. Continuous Schools Awareness (General Directorate of Traffic). 9. The Seatbelt Safe Use Project (1990). 10 Transportation and Traffic Experience (Kindergarten Curriculum, Ministry of Interior/ Ministry of Education, 2006).

Reviewing the progress made in UN's Decade of Action on Road Safety 2011-20, it is clear that much remains to be done. The problem of road safety is reaching pandemic proportions; there are 1.3 million traffic related deaths annually, 50 million are disabled because of injuries from road traffic accidents every year, people road accidents are the 8th leading cause of non-natural death, road accidents are the leading cause of death among 15-29 year olds, 60% of all traffic deaths are among 15-44 year olds, traffic accidents result in a loss equal to 1-2% of national GNP. As road infrastructure expands and becomes better in many parts of the world, and motorisation rates increase, the need to act to address this pandemic on our roads is becoming ever more urgent. In this presentation I will outline a strategy for countries to address the pandemic of death and injury from road accidents. This strategy is based on: • The UN's five pillars – Road safety management, safer roads and mobility, vehicles, road users, and post-crash response, • The safe system approach, • Building political commitment and stakeholder support for improving safety, • Performance management, • Evidence, and • Providing value for money

To achieve significant improvements, there is a need for a systematic approach in Road Safety Management. The first step of such approach is to define the burden of road casualties in the country. Part of defining the burden is the monetary valuation of the prevention of a fatality accident. Such “values of statistical life” are derived in a number of countries, however, there is a large variation among these. Interestingly, a negative correlation seems to exist between the monetary valuation of a statistical life and the road safety situation of a country, namely, countries with low “values of statistical life” have poor road safety situation and vice versa. The next step is to get commitment from decision makers. There is an accumulated knowledge among road safety scientist on what strategies and measures are the most efficient, but without commitment from decision makers, these will not will not be realized. A good example to illustrate this is the case of France, when the President of the country “suddenly” became “… absolutely horrified that French roads are the most dangerous in Europe…”, and ordered tough road safety measures resulting in unpreceded improvements in France’s road safety situation. With the commitment of decision makers, a Road Safety Policy can be established. One example for such policy is the Vision Zero in Sweden, whose parliament passed the Road Traffic Safety Bill on Vision Zero in 1997. Another example is the “Sustainable safety” policy in the Netherlands. Another crucial issue is the creation of a responsible body for road safety on the national level. A National Road Safety Committee/Commission should include the relevant departments, and most importantly be chaired by a committed person, respected by all parties. Before jumping to road safety actions and countermeasures, road safety problems should be identified in a systematic way. When presenting the road safety situation for a country or region, often used risk values build on the number of casualties related to some exposure measure. Some of these exposure measures (number of motor vehicles or motor vehicle kilometres) give a wrong depiction of the situation as they neglect the existence of pedestrians and bicyclists who carry the casualty burden of motorised traffic. To be able to make informed decisions on road safety measures based on accident statistics, we need exposure data for all road user types. Access to exposure data allows us to perform the so called 3-dimensional analysis of road safety problems. The dimensions “exposure” (person-kilometres per year), “risk” (number of injury accidents per person-kilometres per year) and “consequence” (number of killed per number of injury accidents per year) help us to get a good picture of the character of the road safety problems. However, even if this kind of approach gives a good tool for knowledge-based road safety work, several problems exist with using only accidents to analyse the road safety situation; the most obvious of them is that many accidents are never reported. The less the injury severity, the lower the reporting grade. The conclusion from this is that we need to combine Police register with Hospital register on traffic injuries. What’s more, to analyse the traffic safety situation, we also should use non-accident based Safety Performance Indicators. With knowledge of the pattern of road safety problems, Road Safety Targets can be formulated. The targets should embrace targets for road user behaviour, road infrastructure, vehicles and rescue services. A road safety vision without quantified targets will not be effective. Only countermeasures with known effectiveness should be applied. There is an accumulated experience of effectiveness of a large number of road safety countermeasures published in the Handbook of Road Safety Measures. Finally, a very important issue – most often neglected after the introduction of a countermeasure - Monitoring of performance. Data on Safety Performance Indicators should be collected continuously and their status should be followed-up yearly and in the event of deviation from the target, relevant measures should bel applied promptly.

Transportation of Naturally Occurring Radioactive Materials (NORM) Contaminated Waste in QP is carried out in accordance with the Radiation Protection Laws and QP Radiation Protection Standard for NORM Management (QP-STD-S-055). The QP Standard stipulates requirements for ensuring protection of persons and environmental from NORM impact, which is in line with the requirements of the Ministry of Environment (MoE) Resolution No. 45/2013, concerning the management of NORM Waste generated by Oil & Gas Industry in the State of Qatar. In addition, standard provides directions to all QP Operations, Contractors/Sub-Contractors and QP Join Venture companies (JVs) working within QP Premises on-shore and off-shore for identification, handling, transportation, storage and disposal of NORM Waste and related activities. Transportation of the NORM waste is carried out in accordance with the requirements as follows: The radiation level shall not exceed 5 µSv/h at the surface of each container of collected NORM waste. Ends of pipes shall be packed to prevent the spread of contaminated radioactive substances. If the pipes are large enough, such as valves, pumps, packaging shall be for the entire pipe, while taking all necessary precautions to the non-proliferation of pollutants by using of blind flanges. The relatively large quantities of solid pollutants resulting from sediment mud or solid scaly residues shall be transferred in tanks and separation containers. Big decontaminated substances such as substances with low specific radioactivity shall be transported in barrels or tanks according to industrial parcels. No other substances shall be transported in the vehicle transporting substances or equipment contaminated with natural radioactive substances. When transporting NORM waste substances by sea, a suitable container specific for transport shall be used, to ensure no leakage or spillage of pollutants. The licensee, when transporting in any vehicle, shall develop a detailed written transport plan that includes steps to be taken under a state of emergency, and the plan shall be submitted to the Ministry of Environment (MoE). To transfer the components such as valves and non-radioactive pipes, if the surface is contaminated, such as surface polluted objects, the transportation requirements depends on the level of the permanent and non permanent surface contamination emitting of beta and alpha particles. Transportation index shall be designated on each barrel. The choice of the appropriate warning sign to be attached to the barrel is determined by measuring equivalent radiation dose (Micro Sievert/hour) at 1 meter from the surface of the barrel, divided by 10, as well as measuring the equivalent radiation dose on the surface of the barrel directly. To transport the natural radioactive substances or contaminated with these substances, an exclusive-use vehicles shall be used. Boats used to transport substances or contaminated equipment from offshore platforms, shall use standard marked containers. Contaminated substances that cannot be stored in standard containers shall be protected in a controlled manner to ensure no leak or spill of radioactive substances during transport. Before sending the natural radioactive substances, the receiving party shall be notified. Vessel shall be provided with radioactive warning signs, transportation, guide and other specific stickers for transport. QP managed successfully to transport 4 containers (111 drums) of “NORM” from Halul Island to Dukhan HSE Yard No.3, during in October 2014. Part of the process was managed through sea transportation from Halul to Ras Laffan Jetty, and then through land transportation from Ras Laffan to Dukhan. Transportation process was carried out in full compliance with the requirements of Radiation Protection Law No.31 for 2002, Ministerial Decision No. 45 for 2013 regarding NORM Management and Corporate NORM Management Standard QP-STD-S-055. The Job Hazard Analysis (JHA) of the transportation process and transportation date was communicated, discussed and agreed by MoE, 48 hours before transportation date. NORM waste was dispatched to the dedicated Dukhan NORM Storage Yard safely, securely and without any risk for the human and environment, under direct supervision Corporate HSEQ.

The July 1938 issue of the American Journal of Psychology contained an insightful paper on car driving(1). Since that time an enormous technical literature devoted to driving and traffic safety has emerged, resulting in a solid edifice of detailed knowledge(2). Yet many of the most basic questions remain unanswered according to the strictest scientific reasoning. For example, it is widely assumed that we know how a driver’s crash risk is affected by the consumption of alcohol(3). This has never been, nor ever can be, experimentally examined. Likewise, we have no direct experimental investigation of how a driver’s crash risk increases with increasing speed. Our estimate of the effectiveness of safety belts (4) in preventing fatalities rests on an assumption that we know is not true. The most reliable data we do have for most countries is a count of annual fatalities. Even though this is not quite perfect, changes from year to year are accurate provided any biases do not change much from year to year. An assumption-free dimensionless measure not subject to the above problems is a nation’s fatalities in a given year divided by that nation’s maximum number of fatalities in any year(5). Applying this measure to 2013 data from 26 countries leads to a crystal clear conclusion that is even more dramatic and irrefutable than that previously reported using earlier data.5 The USA is a stark outlier. From 1972 to 2013 traffic deaths in the USA declined by 40.1%. This was hailed as success by some USA policy leaders. However, in, for example, the Netherlands traffic deaths in the same period declined by 83.7%. If USA deaths had declined by the same percent as in the Netherlands, then in 2013 the USA would have suffered 8,87532,719 that actually occurred. If the USA had matched the declines recorded in any of 11 countries, then 20,000 fewer Americans would have been killed on the roads of the USA in 2013. The clear message is that the USA approach to safety (to be discussed) needs to change and should never be embraced by any other country. References: 1. Gibson, JJ, Crooks, LE. A theoretical field-analysis of automobile driving, Am J Psych 1938; 5l: 453-7l. Complete text available at http://www.scienceservingsociety.com/GC.htm 2. Evans L. Traffic Safety. Bloomfield Hills, MI: Science Serving Society; 2004. Information at http://www.scienceservingsociety.com/traffic-safety.htm 3. Borkenstein RF, Crowther RF, Shumate RP, Ziel WB, Zylman, R. The role of the drinking driver in traffic accidents. Department of Police Administration, Indiana University; 1964. 4. Evans L. The effectiveness of safety belts in preventing fatalities. Accid Anal Prev. 1986; 18: 229-241. 5. Evans L. Traffic fatality reductions in the United States compared to reductions in 25 countries. Am J Public Health. 2014;104:1501-1507. Available at http://www.scienceservingsociety.com/p/195.pdf

The losses caused by traffic accidents constitutes a large socio-economic problem for the Kingdom of Saudi Arabia and has led to an in-depth study of the driver, which is the major factor in the cause of traffic accidents in any region of the world. The Kingdom of Saudi Arabia's booming economy has resulted in the employment of large numbers of immigrants who work as professional drivers in Saudi Arabia, who come from different cultural and social environments which contributes to an increase in the human factor as the major cause of traffic crashes. This paper summarizes a national study conducted in the Kingdom of Saudi Arabia of 2074 traffic crashes during the year 2011. This study also included interviews of 1067 trainees at driving schools in the same period. The study has shown that the human factor constitutes 76% of the causes of crashes in the study sample and it has also confirmed the increased crash risk for young Saudi drivers when compared to older age groups, it also showed a higher crash involvement of non-Saudi nationals over the age of 30 years. This study concluded that the number of professional drivers involved in traffic crashes from foreign nationalities is higher than the Saudis and Arab drivers, and it also shows that there is an increasing number of non-professional Saudi and Arab drivers involved in traffic crashes when compared with other nationalities. The study also indicated that there was a greater than expected rate of traffic accidents rate involving heavy vehicle drivers when compared to drivers of private vehicles. There is also a higher rate of injury accidents involving drivers of government vehicles than other professional drivers. The study also indicates that drivers of private company and government vehicles are causing more crashes than family drivers and taxi drivers. The study encourages professional drivers to learn and understand the basics of the Arabic language or English, it also recommends that the professional drivers to reassess their driving and health fitness on a regular basis and provide them with training and cultural courses that suit them and more frequent for those who are older than 30 years. The study also recommended the need to increase the standard of training programs in driving schools through utilizing visual media including video and films for the effective delivery of information to trainees of many different nationalities and culturally diverse backgrounds.

- يتلخص البحث بان أي حادث مروري كبير، تكون نتيجته وفاة شخصين على الأقل ، يجب عمل بحث لأسباب الحادث من كل النواحي ،المرورية و الطبية و الهندسية و الأسباب التي أدت للوفاة ، و أي سبب أدى للحادث من ناحية المركبة أو السائق أو الطريق و يقوم رجل المرور و مهندس الطرق و الطبيب ، بعمل تقرير مفصل وميداني بالتنسيق فيما بينهما ، و تحضير التقرير بشكل مختصر يوفي بالغرض و مرفق بالصور و الفيديو، خلال فتر ة من حدوث الحادث لا تتعدى الأسبوعين ، و عرض هذا التقرير أمام كل المهتمين من إدارة المرور و هندسة الطرق و الأطباء ، و بوجود رئيس مجلس الوزراء لأخذ قرارات و قوانين أنية تحد من الحادث الذي قد يحدث بالمستقبل ، و يكون تطبيق هذه القوانين مباشرة كون السلطة العليا بالدولة و المخولة متواجدة ، و نشر ذلك بوسائل الإعلام بعد اخذ الموافقات الرسمية من حيث القوانين و الخصوصية الشخصية.