Author(s): Erin Sauber-Schatz, Erin Parker, Michael Ballesteros

Around the world, thousands of people are killed every day in motor vehicle crashes involving bicycles, buses, cars, motorcycles, trucks, and pedestrians.

Motor Vehicle Crashes: By The Numbers

Annually, ≈1.35 million people are killed (≈3,740 people every day) and an additional 20–50 million are injured in motor vehicle crashes. Road traffic injuries have become the leading cause of death for children and young adults aged 5–29 years. Although only 60% of the world’s vehicles are in low- and middle-income countries, 93% of the world’s crash deaths occur in these countries. More than half of people who die on the world’s roads each year are cyclists, motorcyclists, and pedestrians, also called vulnerable road users.

According to US Department of State data, motor vehicle crashes are the leading cause of nonnatural death among US citizens who die in a foreign country (see Sec. 4, Ch. 12, Injury & Trauma). In 2017 and 2018, 431 US citizens living or traveling internationally died following motor vehicle crashes; 62% of crash deaths occurred among drivers and passengers of passenger vehicles (cars, sport utility vehicles, trucks). Other traffic-related fatalities involved motorcycle drivers and passengers (21%) and pedestrians (8.8%).

Table 8-01 shows the top 30 countries visited by US citizens (2016–2017) based on the Survey of International Air Travelers from the US Department of Commerce. For each country, the table lists the estimated motor vehicle crash death rate per 100,000 population as an indicator for the risk of motor vehicle crash death and the number of US citizens who died in each country because of a crash death from 2017 through 2018.

Motor Vehicle Crashes: Risk Factors

Motor vehicle crashes are common among US citizens traveling abroad for many reasons. In many low- and middle-income countries, unsafe vehicles and an inadequate transportation environment contribute to the crash injury problem. According to the World Health Organization (WHO), vehicles sold in 80% of all countries worldwide fail to meet basic safety standards promoted by the United Nations World Forum for Harmonization of Vehicle Regulations. In addition, motor vehicles share the road with vulnerable road users, and the mix of traffic, including animals, buses, cars, rickshaws, taxis, and large trucks, increases the risk for crashes and injuries.

Speed is another risk factor for vehicular crashes, injuries, and deaths. According to the WHO, speed contributes to about a third of road fatalities in high-income countries and to nearly half in low- and middle-income countries, including fatalities among vulnerable road users. Other factors that contribute to the risk for motor vehicle crashes among travelers include lack of familiarity with the roads, driving on the opposite side of the road, the influence of alcohol, poorly made or inadequately maintained vehicles, travel fatigue, poor road surfaces without shoulders, unprotected curves and cliffs, and absent lighting creating conditions of poor visibility.

Use of protective equipment significantly decreases the risk for injury and death during a vehicle crash. Seat belts, correctly installed children’s booster and car seats, and helmets for bicycle and motorcycle riders reduce crash-related injury and death, but this equipment can be scarce in some countries. In addition, timely and effective emergency and hospital care might be unavailable in some locations. Trauma centers capable of providing optimal care for serious injuries are uncommon outside urban areas in many international destinations.

Motor Vehicle Crashes: Risk Reduction Strategies

Strategies travelers can use to reduce the risks for motor vehicle crash injuries include remaining alert and avoiding distractions when cycling, driving, or walking; choosing transportation carefully (e.g., avoiding overcrowded buses); abstaining from alcohol before driving; and not accepting rides from an impaired driver (see Table 8-02 for more strategies). Travelers should always use seat belts and child safety seats and should rent vehicles with seat belts. Whenever possible, travelers should only ride in taxis with seat belts, and opt for the rear seat. Travelers also should bring car seats or booster seats for their children from home, unless they can be assured of their availability and quality at the destination.

Discourage travelers from driving or riding on motorcycles or motorbikes, including motorcycle and motorbike taxis. For travelers who cannot be dissuaded, strongly recommend that they wear a helmet that meets US safety standards. A good-quality helmet can reduce the risk for death by 40% and for severe injury by 70%.

The Department of State has useful safety information for international travelers, including road safety and security alerts, international driving permits, and travel insurance, along with the Smart Traveler Enrollment Program. In addition, the Association for International Road Travel has useful safety information for international travelers, including road safety checklists and country-specific driving risks.