Drivers' risk profile indicates the need for a graduated driving licence in South Africa

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Abstract

BACKGROUND: Current driver mortality estimates do not consider the great differences in exposure across the population, giving a false impression that driver deaths are lowest in the youngest age group. Interventions to reduce risk among the younger age group include graduated driver licensing (GDL) - a three-phase licensing system for novice drivers consisting of a learner's permit, a provisional license, and a full license. OBJECTIVES: We calculated driver fatality rates per 10 000 registered drivers in each age group and assessed the need for stricter licensing conditions for novice and younger drivers. METHODS: Age-specific driver mortality rates were calculated using Western Cape Province 2008 mortuary data. The total number of licensed drivers in each age group served as the denominator. Incidence rate ratios were calculated using the age group of 65 - 79 years as the reference. Chi-square test of trend on incidence rate ratios for the age groups was done. Statistical significance was set as p<0.05. RESULTS: There were 339 driver deaths; mean age was 39.4±13.8 years, and males accounted for 80% of the deaths. Age-specific driver mortality rates were highest in the youngest age group (15 -19 years). There was a significant progressive decrease (except for the age group 45 - 49 years) in the risk of death from road traffic injuries with increasing age compared with the age group >65 years (chi² for trend p<0.0001). CONCLUSION: This study showed a relationship between driver's mortality risk and younger age, and underscores the need for introduction of a GDL programme in South Africa.

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Initial burden of disease estimates for South Africa, 2000.

Debbie Bradshaw, Pam Groenewald, Ria Laubscher … (2003)

This paper describes the first national burden of disease study for South Africa. The main focus is the burden due to premature mortality, i.e. years of life lost (YLLs). In addition, estimates of the burden contributed by morbidity, i.e. the years lived with disability (YLDs), are obtained to calculate disability-adjusted life years (DALYs); and the impact of AIDS on premature mortality in the year 2010 is assessed. Owing to the rapid mortality transition and the lack of timely data, a modelling approach has been adopted. The total mortality for the year 2000 is estimated using a demographic and AIDS model. The non-AIDS cause-of-death profile is estimated using three sources of data: Statistics South Africa, the National Department of Home Affairs, and the National Injury Mortality Surveillance System. A ratio method is used to estimate the YLDs from the YLL estimates. The top single cause of mortality burden was HIV/AIDS followed by homicide, tuberculosis, road traffic accidents and diarrhoea. HIV/AIDS accounted for 38% of total YLLs, which is proportionately higher for females (47%) than for males (33%). Pre-transitional diseases, usually associated with poverty and underdevelopment, accounted for 25%, non-communicable diseases 21% and injuries 16% of YLLs. The DALY estimates highlight the fact that mortality alone underestimates the burden of disease, especially with regard to unintentional injuries, respiratory disease, and nervous system, mental and sense organ disorders. The impact of HIV/AIDS is expected to more than double the burden of premature mortality by the year 2010. This study has drawn together data from a range of sources to develop coherent estimates of premature mortality by cause. South Africa is experiencing a quadruple burden of disease comprising the pre-transitional diseases, the emerging chronic diseases, injuries, and HIV/AIDS. Unless interventions that reduce morbidity and delay morbidity become widely available, the burden due to HIV/AIDS can be expected to grow very rapidly in the next few years. An improved base of information is needed to assess the morbidity impact more accurately.