Editorial

The end of last year was marked by an important event concerning road safety. The First Global Ministerial Conference on Road Safety was hosted by the Government of the Russian Federation in Moscow on 19^th–20^th November, 2009. The conference recognized the problem described in the 2004 World Health Organisation/World Bank World report on road traffic injury prevention and subsequent publications. The ministerial conference reiterated the fact that road traffic injuries are a major public health problem and a leading cause of death and injury around the world and that road crashes kill more than 1.2 million people and injure as many as 50 million a year, placing road traffic crashes as the leading cause of death for children and young people aged 5–29 years.

Children are the focus of attention in two separate studies that make their appearance in this issue; one of them concerns children and safety concerns in rural north India; and the other, examines non-fatal, unintentional injuries in those below fifteen years of age in Nicaragua. The former is an early population study, of all households in nine contiguous villages with a population of 22,883 people, to emanate from a low/middle income country. The latter article is a pioneering work of its kind based on the records of emergency departments from hospitals in Nicaragua; it has special significance is giving direction and generating political will in addressing an issue like unintentional injuries which have a country-wide health impact.

“Setting feasible national road traffic causality targets that are linked to planned investments and policy initiatives and mobilize the necessary resources to enable effective and sustainable implementation to achieve targets in the framework of a safe systems approach” is an important resolution adopted at the Moscow conference. This obviously highlights the need for effective surveillance systems. In the article from Australia, coding discrepancies in hospitals original datasets and recorded data tells us that there is a need for corrections that would enhance the surveillance system as a whole. The public health study on pedestrians injuries from South Africa is again a pointer to the need for evidence based research. A cross-country study of injury surveillance systems in emergency departments spread over seven countries of Europe comes to the conclusion that the naïve use of such comparisons should be discouraged as they are subject to measurement basis. However, it has to be admitted that such uncommon comparisons conducted across regions or nations can help identify risk areas that demonstrate high variation and as a consequence, potential health gains.

The study on attempted suicide (based on a few, mostly high-income, countries) provides a comprehensive overview of the current state of knowledge about the subject and clarifies where that knowledge comes from and on what segments of the population it is based. It discusses, based on these findings, how best to prevent self-harm or suicide attempts. This study suggests that greater socio-economic disadvantage, both individually and collectively, is associated with higher rates of suicide. But because of the plurality of the confounding factors involved, more complex study designs would seem to be indicated as the authors admit that they do not know whether prevention works best where it may be needed most.

Since research advocacy for railway network safety is non-existent in Pakistan, we have a very interesting study on the subject in this issue. This descriptive work reviewed the deaths and injuries reported on the Pakistan railway network, based on two secondary datasets. The results showed that the railway network related mortality was six times higher than any European country. All the more reason, that there should be more such studies to help plan and implement prevention and safety control measures.

In a first study of its kind – an epidemiological analysis of pedestrian injuries – this work, emanating from a South African municipality is based on data collected by police officers. It was found that adult pedestrians (age between 45 years and 49 years) were most at risk. A high proportion of male pedestrians had blood alcoholic levels above the legal limit. The highest proportion of fatal pedestrian collisions involved trucks and occurred on freeways at night in unlit conditions when the road was wet.