Injury and Environmental Epidemiology, a converging agenda

Reliance on motor vehicle travel and the internal combustion engine has provided mobility, but the public health costs are substantial: Road deaths, adverse deleterious health effects from air pollution and noise, reduction in physical exercise, and toxic hazards associated with the refining, transport, use and disposal of petrochemicals. For traumatic road injury, kinetic energy is the pathogen. Risks for injury and death rise with the second and fourth power of increases in velocity upon impact; emissions of many air pollutants also increase exponentially with speed. Models derived from vector transmission in infectious diseases have proven useful for defining risks and designing interventive strategies. These models predict the number of lives saved and injuries prevented from a package of low-cost, effective measures, which can be quickly implemented. Eradication of road deaths and elimination of air pollution emissions are achievable public health goals. Speed camera systems produce sustainable levels of detection deterring speeding, and thereby reducing human injury and environmental damage. “Education” and building more roads, part of the scenario “predict and provide,” have not been shown to reduce injury risks. Building more roads, which in the long run, promotes urban sprawl and congestion, does not reduce travel time. High speed toll roads and circular beltways, which involve trade-offs among time-saving, risk of injury, and diversion of traffic from population centers, need to be re-evaluated and compared to alternative strategies based on modal shifts. We suggest that revenues resulting from massive use of speed cameras can serve as the first step for funding the first steps of sustainable transportation policies based on developing alternatives to private vehicle use and trucking. Such alternatives could lead to even further reductions in injury and death and adverse effects of air pollution. More involvement by epidemiologists in overseeing and evaluating strategies can expedite progress towards the goal of eradication of deaths from road injury, and at the same time, reduce emissions of air pollutants. This revised version was published online in July 2006 with corrections to the Cover Date.