- Email: [email protected]
The M77 Highway: Saving lives and money
Injury, Int. J. Care Injured (2008) 39, 1071—1074
www.elsevier.com/locate/injury
The M77 Highway: Saving lives and money Evan O.T. Crane *, Angelica Augustine, Gavin R. Tait Department of Orthopaedic Surgery, Crosshouse Hospital, Kilmarnock KA2 0BE, UK Accepted 21 April 2008
KEYWORDS Highway; Accident; Saving; Prevention; Injury; Road traffic accident
Summary Upgrading of a stretch of the A77, a major road in South West Scotland to Highway status has resulted in a significant reduction in the incidence of serious and fatal road traffic accidents on a major international route. Notwithstanding the pain and suffering prevented, the annual economic savings amount to over £6.1 Million ($12.14 M/s7.96 M) The Highway, with an effective central reservation barrier, will pay for itself in 17 years and will continue to prevent serious injury and save lives. # 2008 Elsevier Ltd. All rights reserved.
Introduction The upgrading of a section of the A77, a major transport route to Northern Ireland in South West Scotland, to Highway status — the M77 — was completed in April 2005 at a cost of approximately £78 Million ($155 M/s101.8 M). Associated road improvements in the surrounding area brought the total cost of the project to £132 Million ($262.7 M/ s172.3 M). This upgrade was sanctioned by the Scottish Regional Government in part to improve the transport infrastructure and ease congestion in surrounding towns, but mainly to improve road safety on a route notorious for a high incidence of fatal and serious road traffic accidents (RTA). The original A77 road was a combination of unsegregated dual and single lane road with a speed limit of 60 miles/h, with several dangerous junctions: a con* Corresponding author at: 46 Berryhill Crescent, Wishaw, Lanarkshire ML2 0NF, UK. Tel.: +44 1698 351721. E-mail address: [email protected] (E.O.T. Crane).
figuration which contributed to a high incidence of serious RTAs. On this stretch of the old A77 road, 27 people were killed and another 105 seriously injured in the decade 1993—2003.2 This study assesses the impact of the A77 to M77 road upgrade to Highway status on the number and severity of RTAs before and after the upgrade, and quantifies the health and economic benefits of Highway status.
Methods A retrospective study was made of only those accidents which took place on the 9.4 mile section of the A77 that was upgraded to M77. This allowed direct comparison of only the stretch of road that was upgraded. Under the Freedom of Information (Scotland) Act 2002, a request was made to Strathclyde Police Force to supply details of all RTAs which occurred on the pre-upgrade A77 for the calendar year 2003. Details of all RTAs on the same upgraded
0020–1383/$ — see front matter # 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.injury.2008.04.025
1072 M77 section for the year 1st May 2005—30th April 2006 were made available. These timescales were the last complete year before and the first complete year after the upgrade. During the period January 2004 until April 2005 the Highway was under construction and a 40 mph speed limit was in force along the route and therefore we excluded accidents in this time. Data were provided detailing date, location and severity of the accidents in addition to demographic data about the drivers involved. These data were then used and cross-referenced with Emergency Department admissions at Crosshouse Hospital, Kilmarnock, Scotland which is the hospital that serves this stretch of road. This allowed review of hospital records for any casualties who attended hospital after an RTA. These data were then analysed to establish any difference in the number and severity of RTAs in the two time periods. Annual traffic flow on the road concerned was derived from traffic surveys.3 Features of each RTA were examined and included victim demographics, location and severity of accident. Severity of accident was divided according to the United Kingdom Police naming system: fatal, serious and slight. Slight injuries include minor cuts or bruises. Serious injuries include (a) an injury for which a person is detained in hospital as an in-patient or (b) any of the following injuries (whether or not the person is detained in hospital): fractures, cerebral concussion, internal injuries, crushing, severe cuts and lacerations, severe general shock requiring treatment, or (c) any injury causing death 30 or more days after the accident. The data were analysed by a University lecturer in Mathematics and Statistics using Microsoft Excel 20031. Two tailed tests were used throughout.
Results
E.O.T. Crane et al. were 7 casualties. With an annual traffic flow of 9 million vehicles per year this gives a annual number of casualties of 4.11 per million vehicles prior to the upgrade reducing to 0.78 casualties per million vehicles after the upgrade. This reduction in the annual number of casualties is statistically significant ( p < 0.01).
Annual number of serious injuries/ fatalities In the year before the upgrade there were 13 serious or fatal injuries (10 serious, 3 fatal) and in the year after the upgrade there were no fatalities or serious injuries. With an annual traffic flow of 9 million vehicles per year this gives an annual rate of 1.44 serious/fatal casualties per million vehicles prior to the upgrade, reducing to 0 per million vehicles after the upgrade. This reduction in the annual rate is statistically significant (Fisher’s exact test, p < 0.01). (Note: the number of casualties in the post-upgrade year is too small to use the difference in proportion test used above (which assumes that there are at least 5 incidents in each category) hence Fisher’s exact test is used instead). Table 1 summarises the results and Table 2 shows demographics of the accidents.
Discussion In the last 20 years the total number of road accidents in Scotland of all severities has fallen,1 but the old A77 road continued to suffer a very high incidence. Despite recognised improvements in car design such as airbags, crumple zones and seatbelts Table 1
Accident statistics
Annual number of accidents In the year before the upgrade there were 21 RTAs, and in the year after the upgrade there were 5 RTAs. With an annual traffic flow on the route of 9 million vehicles per year this gives a annual incidence of 2.33 incidents per million vehicles prior to the upgrade reducing to 0.59 incidents per million vehicles after the upgrade. This reduction in the annual incidence of accidents is statistically significant ( p < 0.01).
Annual number of casualties In the year before the upgrade there were 37 casualties and in the year after the upgrade there
Annual accidents Annual casualties Annual serious/ fatal casualties
Table 2
Preupgrade
Postupgrade
p-Value
21 37 13
5 7 0
<0.01 <0.01 <0.01
Accident demographics
Accident features
Preupgrade
Postupgrade
Mean age 35.67 36.31 Male casualties (20/8/3) 31 (4/0/0) 4 (slight/serious/fatal) Total Female casualties (4/2/0) 6 (3/0/0) 3 (slight/serious/fatal) Total
The M77 Highway: Saving lives and money there remained an unacceptably high incidence of severe and fatal injuries in these accidents. The M77 Highway upgrade has a number of features including improved road surface, safer configuration of junctions, more lighting at these junctions and most importantly, a central wire barrier which separates the high speed northbound and southbound traffic flows There is clear evidence that the upgrading of this 9.4 mile stretch of A77 road to M77 Highway status has significantly reduced the number of road traffic accidents, the number of casualties and also severity of injury of those casualties sustained in these accidents. Fig. 1 gives an overview of the location of the Highway between the markers. The United Kingdom Department for Transport uses a method for calculating both the human and the economic cost of road accidents.1 The human cost covers an amount to reflect the pain, grief and suffering to the casualty, relatives and friends, and,
Figure 1
1073 for fatal casualties, the intrinsic loss of enjoyment of life over and above the consumption of goods and services. The economic cost covers loss of output due to injury and medical costs. The cost of an accident also includes the cost of damage to vehicles and property and the cost of police and insurance administration. In the United Kingdom, the cost of one fatality is £1.42 Million ($2.83 M/ s1.85 M). A serious injury costs £160,510 ($319,415/s209,466) and a slight injury £12,375 ($24,626/s16,149). The mean cost per casualty regardless of severity is £44,927 ($89,405/ s58,630). From Table 3 it can be seen that although the initial outlay to build the road was considerable (£78 M/$155 M/s101.8 M), prevention of deaths and serious accidents result in marked financial savings for the government and in addition to the economic benefits for businesses, it is likely the government will recoup the building costs over
Location of Highway between markers.
1074
E.O.T. Crane et al.
Table 3 Accident costs Accident costs for each complete year £ Million ($M/sM) Casualties A77 pre-upgrade M77 post-upgrade
Slight 0.297 0.087
Serious 1.605 0
the life of the road. Using these figures it is possible to calculate the direct economic savings from the M77 road upgrade. Table 3 illustrates these. Furthermore, ‘‘Connect Roads’’, a subsidiary of Balfour Beatty plc which maintains the upgraded M77 Highway provided information from their records indicating that since the road opened (April 2005), they have made repairs to the central reservation wire barriers 17 times, on average once per month. Prior to the road upgrade, these incidents could potentially have been high speed head on collisions. Given that such accidents may result in at least 2 casualties costing an average £90,000 ($179,100/s117,450) and allied to the fact that each repair to the barrier costs between £500 ($995/s652) and £2000 ($3980/s2610), it can be seen that the new central reservation barrier helps to prevent serious accidents and is a very costeffective preventative measure for road traffic accidents, perhaps saving a further £1 Million ($1.99 M/ s1.305 M) per year. Thus replacement of 9.4 miles of old carriageway with Highway can be seen to have saved lives and prevented injuries by reducing the incidence of road traffic accidents, and may have led to a minimum saving to the overall economy of £6.1 Million ($12.14 M/s7.96 M) annually, notwithstanding the economic benefits to businesses Given the initial cost of the M77 (£78 M/$155 M/s101.8 M), the project will have paid for itself in under 13 years. As the design life of the M77 may be 40 years this project can be demonstrated to be highly successful in both human and economic terms. We feel that this paper has an important message which can be exported out of the United Kingdom and can be applied in any country. As trauma has such a profound human and financial impact, part of our duty as trauma surgeons must be to encourage the prevention of trauma. We are more familiar with this concept at an individual level, for example hip protectors and medication to treat osteoporosis in the context of hip fractures. Our paper illustrates that undertaking a major road safety upgrade, especially in areas which have an unusually high accident rate can have a significant impact on the number and severity of RTAs. This paper shows that although the initial costs of such a project are considerable,
Fatal 4.285 0
Total 6.187 (12.31/8.07) 0.087 (0.173/0.113)
in the long run there are clear economic and human benefits to be gained over the lifespan of the road. Trauma surgeons have a moral obligation to encourage their local and national governments to invest in road safety, especially where a particular accident risk has developed. This paper can strengthen the case for such investment from a human, financial and political perspective. There are some limitations to this study. Only 1 year of complete data was available for the postupgrade period at time of writing. Analysing with the average yearly crash statistics may have been a fairer comparison. Future work will look at the statistics for a longer period of time both before and after the Highway upgrade. Also, there is the potential that traffic flow may have increased over the time period of the study, which could dilute the impact of the road upgrade on the improvement in accident statistics. No information was available that detailed any increase in traffic flow during the study period.
Acknowledgement Thanks to Mario Hair, Lecturer in Statistics & Mathematics at the University of Paisley, Paisley, UK for his assistance in analysing the data.
Conflict of interest None declared.
References 1. Road Accidents Scotland 2005–—A Scottish Executive National Statistics Publication, pp. 14, 102—03 [http://www.scotland.gov.uk/Topics/Statistics/Browse/Transport-Travel/TablesPublications/RoadAccidentsScotland2005]. 2. Scottish Executive News Release 27/04/2005 [http:// www.scotland.gov.uk/News/Releases/2005/04/27094715]. 3. Scottish Transport Statistics No.25, 2006 Edition–—A Scottish Executive National Statistics Publication, pp. 133 [http:// www.scotland.gov.uk/Topics/Statistics/Browse/TransportTravel/TablesPublications/STS25].
www.elsevier.com/locate/injury
The M77 Highway: Saving lives and money Evan O.T. Crane *, Angelica Augustine, Gavin R. Tait Department of Orthopaedic Surgery, Crosshouse Hospital, Kilmarnock KA2 0BE, UK Accepted 21 April 2008
KEYWORDS Highway; Accident; Saving; Prevention; Injury; Road traffic accident
Summary Upgrading of a stretch of the A77, a major road in South West Scotland to Highway status has resulted in a significant reduction in the incidence of serious and fatal road traffic accidents on a major international route. Notwithstanding the pain and suffering prevented, the annual economic savings amount to over £6.1 Million ($12.14 M/s7.96 M) The Highway, with an effective central reservation barrier, will pay for itself in 17 years and will continue to prevent serious injury and save lives. # 2008 Elsevier Ltd. All rights reserved.
Introduction The upgrading of a section of the A77, a major transport route to Northern Ireland in South West Scotland, to Highway status — the M77 — was completed in April 2005 at a cost of approximately £78 Million ($155 M/s101.8 M). Associated road improvements in the surrounding area brought the total cost of the project to £132 Million ($262.7 M/ s172.3 M). This upgrade was sanctioned by the Scottish Regional Government in part to improve the transport infrastructure and ease congestion in surrounding towns, but mainly to improve road safety on a route notorious for a high incidence of fatal and serious road traffic accidents (RTA). The original A77 road was a combination of unsegregated dual and single lane road with a speed limit of 60 miles/h, with several dangerous junctions: a con* Corresponding author at: 46 Berryhill Crescent, Wishaw, Lanarkshire ML2 0NF, UK. Tel.: +44 1698 351721. E-mail address: [email protected] (E.O.T. Crane).
figuration which contributed to a high incidence of serious RTAs. On this stretch of the old A77 road, 27 people were killed and another 105 seriously injured in the decade 1993—2003.2 This study assesses the impact of the A77 to M77 road upgrade to Highway status on the number and severity of RTAs before and after the upgrade, and quantifies the health and economic benefits of Highway status.
Methods A retrospective study was made of only those accidents which took place on the 9.4 mile section of the A77 that was upgraded to M77. This allowed direct comparison of only the stretch of road that was upgraded. Under the Freedom of Information (Scotland) Act 2002, a request was made to Strathclyde Police Force to supply details of all RTAs which occurred on the pre-upgrade A77 for the calendar year 2003. Details of all RTAs on the same upgraded
0020–1383/$ — see front matter # 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.injury.2008.04.025
1072 M77 section for the year 1st May 2005—30th April 2006 were made available. These timescales were the last complete year before and the first complete year after the upgrade. During the period January 2004 until April 2005 the Highway was under construction and a 40 mph speed limit was in force along the route and therefore we excluded accidents in this time. Data were provided detailing date, location and severity of the accidents in addition to demographic data about the drivers involved. These data were then used and cross-referenced with Emergency Department admissions at Crosshouse Hospital, Kilmarnock, Scotland which is the hospital that serves this stretch of road. This allowed review of hospital records for any casualties who attended hospital after an RTA. These data were then analysed to establish any difference in the number and severity of RTAs in the two time periods. Annual traffic flow on the road concerned was derived from traffic surveys.3 Features of each RTA were examined and included victim demographics, location and severity of accident. Severity of accident was divided according to the United Kingdom Police naming system: fatal, serious and slight. Slight injuries include minor cuts or bruises. Serious injuries include (a) an injury for which a person is detained in hospital as an in-patient or (b) any of the following injuries (whether or not the person is detained in hospital): fractures, cerebral concussion, internal injuries, crushing, severe cuts and lacerations, severe general shock requiring treatment, or (c) any injury causing death 30 or more days after the accident. The data were analysed by a University lecturer in Mathematics and Statistics using Microsoft Excel 20031. Two tailed tests were used throughout.
Results
E.O.T. Crane et al. were 7 casualties. With an annual traffic flow of 9 million vehicles per year this gives a annual number of casualties of 4.11 per million vehicles prior to the upgrade reducing to 0.78 casualties per million vehicles after the upgrade. This reduction in the annual number of casualties is statistically significant ( p < 0.01).
Annual number of serious injuries/ fatalities In the year before the upgrade there were 13 serious or fatal injuries (10 serious, 3 fatal) and in the year after the upgrade there were no fatalities or serious injuries. With an annual traffic flow of 9 million vehicles per year this gives an annual rate of 1.44 serious/fatal casualties per million vehicles prior to the upgrade, reducing to 0 per million vehicles after the upgrade. This reduction in the annual rate is statistically significant (Fisher’s exact test, p < 0.01). (Note: the number of casualties in the post-upgrade year is too small to use the difference in proportion test used above (which assumes that there are at least 5 incidents in each category) hence Fisher’s exact test is used instead). Table 1 summarises the results and Table 2 shows demographics of the accidents.
Discussion In the last 20 years the total number of road accidents in Scotland of all severities has fallen,1 but the old A77 road continued to suffer a very high incidence. Despite recognised improvements in car design such as airbags, crumple zones and seatbelts Table 1
Accident statistics
Annual number of accidents In the year before the upgrade there were 21 RTAs, and in the year after the upgrade there were 5 RTAs. With an annual traffic flow on the route of 9 million vehicles per year this gives a annual incidence of 2.33 incidents per million vehicles prior to the upgrade reducing to 0.59 incidents per million vehicles after the upgrade. This reduction in the annual incidence of accidents is statistically significant ( p < 0.01).
Annual number of casualties In the year before the upgrade there were 37 casualties and in the year after the upgrade there
Annual accidents Annual casualties Annual serious/ fatal casualties
Table 2
Preupgrade
Postupgrade
p-Value
21 37 13
5 7 0
<0.01 <0.01 <0.01
Accident demographics
Accident features
Preupgrade
Postupgrade
Mean age 35.67 36.31 Male casualties (20/8/3) 31 (4/0/0) 4 (slight/serious/fatal) Total Female casualties (4/2/0) 6 (3/0/0) 3 (slight/serious/fatal) Total
The M77 Highway: Saving lives and money there remained an unacceptably high incidence of severe and fatal injuries in these accidents. The M77 Highway upgrade has a number of features including improved road surface, safer configuration of junctions, more lighting at these junctions and most importantly, a central wire barrier which separates the high speed northbound and southbound traffic flows There is clear evidence that the upgrading of this 9.4 mile stretch of A77 road to M77 Highway status has significantly reduced the number of road traffic accidents, the number of casualties and also severity of injury of those casualties sustained in these accidents. Fig. 1 gives an overview of the location of the Highway between the markers. The United Kingdom Department for Transport uses a method for calculating both the human and the economic cost of road accidents.1 The human cost covers an amount to reflect the pain, grief and suffering to the casualty, relatives and friends, and,
Figure 1
1073 for fatal casualties, the intrinsic loss of enjoyment of life over and above the consumption of goods and services. The economic cost covers loss of output due to injury and medical costs. The cost of an accident also includes the cost of damage to vehicles and property and the cost of police and insurance administration. In the United Kingdom, the cost of one fatality is £1.42 Million ($2.83 M/ s1.85 M). A serious injury costs £160,510 ($319,415/s209,466) and a slight injury £12,375 ($24,626/s16,149). The mean cost per casualty regardless of severity is £44,927 ($89,405/ s58,630). From Table 3 it can be seen that although the initial outlay to build the road was considerable (£78 M/$155 M/s101.8 M), prevention of deaths and serious accidents result in marked financial savings for the government and in addition to the economic benefits for businesses, it is likely the government will recoup the building costs over
Location of Highway between markers.
1074
E.O.T. Crane et al.
Table 3 Accident costs Accident costs for each complete year £ Million ($M/sM) Casualties A77 pre-upgrade M77 post-upgrade
Slight 0.297 0.087
Serious 1.605 0
the life of the road. Using these figures it is possible to calculate the direct economic savings from the M77 road upgrade. Table 3 illustrates these. Furthermore, ‘‘Connect Roads’’, a subsidiary of Balfour Beatty plc which maintains the upgraded M77 Highway provided information from their records indicating that since the road opened (April 2005), they have made repairs to the central reservation wire barriers 17 times, on average once per month. Prior to the road upgrade, these incidents could potentially have been high speed head on collisions. Given that such accidents may result in at least 2 casualties costing an average £90,000 ($179,100/s117,450) and allied to the fact that each repair to the barrier costs between £500 ($995/s652) and £2000 ($3980/s2610), it can be seen that the new central reservation barrier helps to prevent serious accidents and is a very costeffective preventative measure for road traffic accidents, perhaps saving a further £1 Million ($1.99 M/ s1.305 M) per year. Thus replacement of 9.4 miles of old carriageway with Highway can be seen to have saved lives and prevented injuries by reducing the incidence of road traffic accidents, and may have led to a minimum saving to the overall economy of £6.1 Million ($12.14 M/s7.96 M) annually, notwithstanding the economic benefits to businesses Given the initial cost of the M77 (£78 M/$155 M/s101.8 M), the project will have paid for itself in under 13 years. As the design life of the M77 may be 40 years this project can be demonstrated to be highly successful in both human and economic terms. We feel that this paper has an important message which can be exported out of the United Kingdom and can be applied in any country. As trauma has such a profound human and financial impact, part of our duty as trauma surgeons must be to encourage the prevention of trauma. We are more familiar with this concept at an individual level, for example hip protectors and medication to treat osteoporosis in the context of hip fractures. Our paper illustrates that undertaking a major road safety upgrade, especially in areas which have an unusually high accident rate can have a significant impact on the number and severity of RTAs. This paper shows that although the initial costs of such a project are considerable,
Fatal 4.285 0
Total 6.187 (12.31/8.07) 0.087 (0.173/0.113)
in the long run there are clear economic and human benefits to be gained over the lifespan of the road. Trauma surgeons have a moral obligation to encourage their local and national governments to invest in road safety, especially where a particular accident risk has developed. This paper can strengthen the case for such investment from a human, financial and political perspective. There are some limitations to this study. Only 1 year of complete data was available for the postupgrade period at time of writing. Analysing with the average yearly crash statistics may have been a fairer comparison. Future work will look at the statistics for a longer period of time both before and after the Highway upgrade. Also, there is the potential that traffic flow may have increased over the time period of the study, which could dilute the impact of the road upgrade on the improvement in accident statistics. No information was available that detailed any increase in traffic flow during the study period.
Acknowledgement Thanks to Mario Hair, Lecturer in Statistics & Mathematics at the University of Paisley, Paisley, UK for his assistance in analysing the data.
Conflict of interest None declared.
References 1. Road Accidents Scotland 2005–—A Scottish Executive National Statistics Publication, pp. 14, 102—03 [http://www.scotland.gov.uk/Topics/Statistics/Browse/Transport-Travel/TablesPublications/RoadAccidentsScotland2005]. 2. Scottish Executive News Release 27/04/2005 [http:// www.scotland.gov.uk/News/Releases/2005/04/27094715]. 3. Scottish Transport Statistics No.25, 2006 Edition–—A Scottish Executive National Statistics Publication, pp. 133 [http:// www.scotland.gov.uk/Topics/Statistics/Browse/TransportTravel/TablesPublications/STS25].