Health burden of road traffic accidents, an analysis of clinical data on disability and mortality exposure rates in Flanders and Brussels.

Statistics on road traffic accidents (RTAs) mainly come from police records. The police reported RTA statistics however are known to have a large degree of under-registration, underestimating the true risk of being injured in traffic accidents. The use of medical based datasets can provide a more accurate estimate of the actual traffic accident health risk. Exposure-based rates of the actual burden from Flanders and Brussels were calculated, comparing differences between road user, age, gender and type of injury sustained. Minimal Clinical Data (MCD) was selected for the years 2003-2007, as well as data from the mortality statistics. Disability Adjusted Life Years (DALY) were calculated and put into perspective with the passenger kilometres travelled. Motorcyclists followed by bicyclists and pedestrians showed a higher DALY per travelled kilometre (6365, 1724 and 1359 DALY per billion kilometres respectively), compared to 113 DALY per billion kilometres for motor vehicles. In bicyclists and to lesser extent in motorcyclists, the majority of the health burden was attributed to disability following injuries and not fatalities. Also in the other road user categories disability added substantially to the total health loss. The use of medical data and more particular the MCD may be a valuable addition of those RTAs that are missed by the police scope. Although the results are still conservative estimations, an injury-based approach can help to better understand the health problem that road traffic accidents cause.