Title:
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Epidemiology and economic impact of road traffic accidents in the United Arab Emirates
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High rates of serious road traffic accidents (RTAs) have been reported for the United Arab Emirates (UAE), in recent years. This research aims to describe the problem in the UAE and to quantify its economic burden on the country’s resources. The approach chosen is quantitative, based on methods of RTA epidemiology and economic evaluation. The research is carried in two parts. Part one attempts to identify trends of morbidity and mortality from RTAs during 1981-1995, to compare the magnitude of the problem with other countries, to evaluate information available on possible causes, to estimate future forecasts of the problem and to analyse RTA injury severity before and after enforcing seatbelt legislation. The results of part one provide the basis to evaluate the economic impact of the problem during 1995 and to estimate the rational investment levels for improving safety and health, in part two. The Human Capital (HC) approach is used to estimate the economic costs of RTAs in the UAE during 1995. To estimate RTA comprehensive costs the study adds to the latter the costs of pain, grief and suffering (PGS) to RTA victims, drawn worldwide, using the Willingness to Pay (WTP) value approach. Data were obtained from police, health and WHO sources to describe trends in morbidity and mortality from 1981 to 1995. The results revealed that during the period 1981-1995, the rates of RTAs per 100,000 population and per 100,000 motor vehicles declined in the UAE by a trend component of -96.5 (p<0.001; R2 =0.69) and by -522 (p<. 001; R 2 =0.92) respectively. RTA specific fatality rates based on the same two denominators also declined by -1.1 (p<. 02; R2 =0.56) and -5.1 (p<.02; R2 =0.330); and injury rates declined by a trend component of -6.8 (p<. 01; R2 =0.341) and -28.0 (p= n.s.) respectively. Paradoxically, however, except for a short period (1981-1985), a steady increase in the risk of injury and death in each RTA accompanied these declines. Between 1985 - 1995 the severity rate of RTA injuries more than doubled (p<.001). The UAE’s specific fatality rates per 100,000 population and per 100,000 motor vehicles were high when compared with other countries. The reason for the increasing severity is not clear, but drivers aged between 18 and 40 years were mostly implicated in fatalities. When injury severity was measured before and after the enforcement of seat-belt legislation in 1999, a significant downward trend in injury severity occurred when seat belts were worn (chi-Square = 77.68, p<0.0001). The total economic cost of RTAs in the UAE during 1995 amounted to AED 3.8 billion, equivalent to US$ 1 billion, representing 2-3% of the annual GDP. Out of that, the direct monetary costs of RTA fatalities and injuries exceeded AED 1 billion while the indirect costs accounted for the rest. The comprehensive costs of RTAs in the UAE amounted to AED 11.4 billions and ranged from AED 50,000 per minor injury to AED 7.5 million per fatality, roughly 4 times the economic costs of these events. This indicates that it is rational public policy to invest up to AED 50,000 to enhance safety and health to prevent one minor injury and up to AED 7.5 millions to prevent one death. The thesis makes many recommendations to improve future epidemiological and economic analysis of RTAs in the UAE. It is hoped that this study will form a useful base for evaluation when these studies take place and for establishing cost benefit ratios and, therefore, priority for future prevention strategies.
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