Motor vehicle collisions are one of the leading circumstances of death worldwide and are contributory to the second most common circumstance of death in South Africa, “transport-related deaths”. A total of 3248 transport-related deaths were recorded in Gauteng alone in 2009 and for that reason motor vehicle collisions pose a substantial threat to the South African population. This study was undertaken to determine if specific patterns of injuries in victims of fatal motor vehicle collisions existed. For the purposes of this study, “patterns of injury” can be defined as similar injuries of similar severities repeatedly and predictably occurring in similar body regions. The study consisted of all individuals involved in fatal collisions who fit the inclusion criteria during the period between 13 May 2011 and 1 June 2012. The external, visceral, and skeletal injuries sustained by the individuals involved in fatal motor vehicle collisions were observed via x-ray and photographic procedures performed by the investigator, as well as documentation from the Forensic Medical Practitioner/scribe notes. The South African Police Force attending officer’s affidavit and the Johannesburg Metropolitan Police Force Accident Reports were used to determine the make and model of the vehicle, the occupant’s position, type of collision and object with which the vehicle collided. The study’s results indicated that distinct patterns of injuries existed for those individuals involved in fatal motor vehicle collisions. The most frequently observed patterns of injuries included either severe head injuries in isolation, severe thoracic and/or abdominal injuries in isolation, or a combination of the two. Distinct patterns of injuries were noted for individuals occupying different types of vehicles but not for individuals occupying different positions within a single vehicle which is contrary to other international findings.

Child road trauma poses a preventable public health burden to the community. This PhD research aimed to: 1) quantify the magnitude of child passenger injuries in New South Wales (NSW), Australia; 2) evaluate the effectiveness of different restraint use to prevent fatalities among child passengers; and 3) estimate the benefit in the general child population from different intervention targets relating to restraint use. It comprised two studies to validate methodology and four independent epidemiological studies. The first study to validate methodology assessed the data item availability and categorization across different road traffic injury surveillance data collections in NSW in relation to World Health Organization recommended data item lists and necessary data item lists for road traffic injury research. Exclusion of, or insufficient categorization of, crucial data items such as restraint use and injurious outcome existed for each data collection. The other study to validate methodology assessed the performance (in terms of incidence estimates, sensitivity, and specificity) of several methods for removing multiple counting when conducting analyses on hospital separation data for child passenger injuries under either primary-diagnosis or all-diagnoses based injury definition, using linkage methods as a comparison. The "readmission"-based criterion consistently best approximated the linkage-method-derived incidence rate. Two epidemiological studies used NSW hospital separation datasets and quantified the magnitude of child road trauma in NSW in terms of hospitalisation rates. One study examined the trend in hospitalised injury incidence rates during the period of July 1998 to June 2005 using a non-parametric estimation method, and reported a non-significant decline of hospitalised injuries to child passengers over time. The second study used Poisson regression to demonstrate that rural NSW children were two times more likely to suffer hospitalised injuries compared with their urban counterparts. The third epidemiological study used the Fatality Analysis Reporting Systems (FARS) from the United States (US) and estimated the association between different restraint uses and child passenger fatality using a matched cohort method. Improperly using restraints significantly elevated the risk of death for child passengers involved in a crash compared to any other restraint use. The advantage of child restraints over seat belts in terms of fatality reduction was not statistically significant, although previous studies have shown an advantage for serious injury reduction. The last study was performed to quantify the relative public health benefit in terms of reduction in child passenger deaths and injuries for different interventions relating to restraint use in the general population using a case-based population attributable risk fraction method. Results support the ongoing child restraint legislation change in Australia to require compulsory child restraint uses for children up to their 7th birthday, and an increasing proper use of age-appropriate restraints would provide the greatest reduction in fatalities and injuries among child passengers assuming equal population uptake for all interventions. In conclusion, this thesis demonstrates that child road trauma remains a public health burden to the Australian community; and highlights the importance of properly using age-appropriate restraints in preventing injuries to child passengers.

Child road trauma poses a preventable public health burden to the community. This PhD research aimed to: 1) quantify the magnitude of child passenger injuries in New South Wales (NSW), Australia; 2) evaluate the effectiveness of different restraint use to prevent fatalities among child passengers; and 3) estimate the benefit in the general child population from different intervention targets relating to restraint use. It comprised two studies to validate methodology and four independent epidemiological studies. The first study to validate methodology assessed the data item availability and categorization across different road traffic injury surveillance data collections in NSW in relation to World Health Organization recommended data item lists and necessary data item lists for road traffic injury research. Exclusion of, or insufficient categorization of, crucial data items such as restraint use and injurious outcome existed for each data collection. The other study to validate methodology assessed the performance (in terms of incidence estimates, sensitivity, and specificity) of several methods for removing multiple counting when conducting analyses on hospital separation data for child passenger injuries under either primary-diagnosis or all-diagnoses based injury definition, using linkage methods as a comparison. The "readmission"-based criterion consistently best approximated the linkage-method-derived incidence rate. Two epidemiological studies used NSW hospital separation datasets and quantified the magnitude of child road trauma in NSW in terms of hospitalisation rates. One study examined the trend in hospitalised injury incidence rates during the period of July 1998 to June 2005 using a non-parametric estimation method, and reported a non-significant decline of hospitalised injuries to child passengers over time. The second study used Poisson regression to demonstrate that rural NSW children were two times more likely to suffer hospitalised injuries compared with their urban counterparts. The third epidemiological study used the Fatality Analysis Reporting Systems (FARS) from the United States (US) and estimated the association between different restraint uses and child passenger fatality using a matched cohort method. Improperly using restraints significantly elevated the risk of death for child passengers involved in a crash compared to any other restraint use. The advantage of child restraints over seat belts in terms of fatality reduction was not statistically significant, although previous studies have shown an advantage for serious injury reduction. The last study was performed to quantify the relative public health benefit in terms of reduction in child passenger deaths and injuries for different interventions relating to restraint use in the general population using a case-based population attributable risk fraction method. Results support the ongoing child restraint legislation change in Australia to require compulsory child restraint uses for children up to their 7th birthday, and an increasing proper use of age-appropriate restraints would provide the greatest reduction in fatalities and injuries among child passengers assuming equal population uptake for all interventions. In conclusion, this thesis demonstrates that child road trauma remains a public health burden to the Australian community; and highlights the importance of properly using age-appropriate restraints in preventing injuries to child passengers.

A modern society is often characterized by a large measure of welfare that all citizens take part of to a greater or lesser extent. Welfare can be defined as the social rights and benefits enjoyed by the habitants of a country. In Sweden, the social safety net is well developed and offers financial compensation in several situations and the individual can safely rely on the social safety net. In addition, legislations and insurances have been developed to offer protection to the habitants in special deserving cases. For example, when a person gets injured at the work-place or in traffic there are insurances that allow compensation regardless of any negligence, so called culpa. The insurance form is called no fault insurances. In addition, there is tort law that is applicable on all non-contractual damages. Tort law, private insurance law, insurances due to collective bargaining, public insurances covering occupation as well as different areas of the social security system are all connected in a vast and complex structure. The main purpose of the essay is to analyze the interdependence between the different compensation systems and to examine the differences that the no fault insurances concerning work related injuries and injuries due to traffic shows between them but also in comparison with tort law regarding for example compensation and the possibility to appeal a “wrongfully” made decision. The first part of the essay will provide a historical background to the development of the no fault insurances, especially regarding occupational damage and accidents in traffic, and focus on the relation between the different compensation systems - the Swedish model. Further on the motives to the regulations will be examined, followed by cases illustrating the actual application and specialness of the regulations. Analyzes and conclusions will be found in the different chapters of the essay, and they will be put together in a final chapter.

L’attention est un prérequis à l’exécution de la majorité des tâches que nous réalisons au quotidien. Si notre niveau d’attention fluctue naturellement au cours de la journée, de nombreux facteurs peuvent également altérer notre niveau de vigilance (p. ex. alcool, médicaments) ou détourner notre attention (p. ex. téléphone, pensées) et, dès lors, nous exposer à un risque d’accident. En accidentologie routière, les défauts d’attention sont devenus un enjeu de préoccupation majeur, mais des questions demeurent en suspens. Et qu’en est-il des autres traumatismes non intentionnels ? L’objectif de ce travail de thèse était d’étudier le rôle des défauts d’attention dans la survenue de traumatismes non intentionnels. Il s’agissait d’explorer des questions épidémiologiques restées en suspens en accidentologie routière tout en élargissant la problématique à ces accidents moins connus que sont les accidents de la vie courante (AcVC). Pour ce faire, trois axes ont été explorés. Le premier a consisté à étudier le lien entre consommation de médicaments et risque d’accident de la route chez les piétons en s’appuyant sur l’appariement des données sur les remboursements de médicaments de l’Assurance Maladie avec celles sur les accidents de la circulation recueillies par les forces de l’ordre. Dans un second temps, nous nous sommes intéressés à la problématique des différents types de distraction au volant. Cette seconde partie a reposé sur les données d’une étude menée au CHU de Bordeaux. Enfin, un dernier axe a consisté à étudier le rôle des défauts d’attention dans la survenue des AcVC en s’appuyant sur les données d’une cohorte prospective et en ligne sur les AcVC. Dans cette dernière étude, les défauts d’attention ont été étudiés sous l’angle du mind-wandering en tant que trait mesuré par le biais d’un questionnaire ainsi que par l’implémentation de trois tests neuropsychologiques en ligne. Plusieurs classes de médicaments, dont les benzodiazépines, étaient associées à une augmentation du risque d’accident chez les piétons. Dans l’étude sur la distraction au volant, la distraction visuelle a été identifiée comme étant celle qui présentait le plus de risque. Enfin, si aucun lien n’a été trouvé entre les mesures aux tests neuropsychologiques et le risque d’accident de la vie courante, le mind-wandering trait a été associé à une augmentation du risque d’accident de type sports, loisirs et déplacements. Ce travail fournit un éclairage essentiel sur des questions restées jusqu’ici inexplorées. Au-delà des conducteurs et du risque routier, nos résultats indiquent que les défauts d’attention pourraient également présenter un risque pour les piétons ainsi que pour la survenue d’autres accidents du quotidien. Dans les années à venir, la part des défauts d’attention dans la survenue de traumatismes devrait encore croître du fait notamment de l’utilisation croissante des nouvelles technologies dans notre quotidien. Par conséquent, mieux comprendre le rôle de ces défauts d’attention dans la survenue de traumatismes non intentionnels est plus que jamais essentiel. / Attention is a complex process that is required in almost all our daily activities. Beyond its natural fluctuation during the day, our level of attention is also influenced by a large range of factors that can diminish our level of alertness (e.g. medicines, alcohol use) or divert our attention (e.g. mobile phone, thoughts) thus exposing us to the occurrence of unintentional injuries. In road traffic safety, attention failures have been identified as a major cause of concern but questions remain unsolved. What about attentional failures in the occurrence of daily-life injuries ? The aim of this thesis was to explore the role of attention failures on the risk of unintentional injuries. The idea was to explore epidemiological issues that remained unresolved in road traffic injuries while extending the problematic to those lesser-known injuries that are Home and Leisure Injuries (HLIs). To that end, this thesis was divided in three parts. First, we investigated the association between medicine use and the risk of road traffic injuries among pedestrians. To do that, we used data on road traffic crashes collected by the French police forces matching with data on reimbursed medicine from the French Health insurance. In a second part, we were interested in several types of driving distractions on the risk of road traffic crashes using data from a sample of road users interviewed at the Bordeaux University Hospital. The third and final part was to study the role of attentional failures on the occurrence of HLIs and was based on data from a prospective and online cohort on HLIs. Attentional failures were studied from the perspective of mind-wandering as a trait measured through a questionnaire and also the implementation of three online neuropsychological tests. Several medicine classes, including benzodiazepines, were associated with an increased risk of being involved in a road traffic crash as a pedestrian. In the study on distracted driving, the higher risk was found for visual distraction. Finally, whereas neuropsychological test scores were not associated with a higher risk of HLI, mind-wandering trait was associated with a higher risk of sport, leisure and moving-related injuries. This work provides essential insights into issues that have remained unexplored to date. Beyond the drivers and road risk, our results indicate that attentional failures could also present a risk for pedestrians as well as for the occurrence of other everyday injuries. In years, to come, the share of attentional failures in the occurrence of injuries is expected to further increase, particularly due to the increasing use of new technologies in our daily live. Therefore, a better understanding of the role of these attentional failures in the occurrence of unintentional injuries is more than ever essential.

The overall aim of this thesis was to describe experiences of emergency treatment among people injured in traffic accidents, and to test and evaluate the effects of follow-up telephone calls from a nurse during the subsequent phase. The thesis is based on four sub-studies of motorists, bicyclists, and pedestrians who had fallen in traffic during the years 2002-2005. The participants were aged 18 to 70 years old and had minor (MAIS 1) or nonminor (MAIS 2+) injuries. Sub-study I was a qualitative study in which individual narrative interviews were conducted with nine persons who had sustained traffic injuries. The aim of this study was to describe the injured individuals’ experiences of pre-hospital and hospital care and subsequent rehabilitation. The interviews were analysed using content analysis, and the experiences of the interviewees were formulated into four themes: facing commotion, experiencing trust and security, lacking security and support, and struggling to return to everyday life. The results showed that a sensitive caregiver who provides comprehensible information facilitates both the emergency treatment and the subsequent period of care and rehabilitation. Sub-study II was a cross-sectional study in which the participants (n=565) estimated their perceptions of the quality of care in the accident and emergency department (A&E) after an injury event. The Mini-KUPP (“Quality from the Patient’s Perspective”) questionnaire was used to estimate quality of care at the A&E. The questionnaire was posted to the subjects’ home addresses three weeks after the visit to the A&E. The results showed that the quality of care was scored on the top half of the scale by all three road user categories. In a multiple logistic regression analysis, significant connections emerged between good quality of care and a short waiting time, non-minor injuries (MAIS2+), higher age, and higher levels of education. The factor most closely associated with the perception of good quality of care was a short waiting time. Sub-study III was a stratified and randomised intervention study including 568 injured persons. In addition to modern trauma care, the intervention group received follow-up via telephone, three weeks after the injury, by a nurse who provided advice and support during the rehabilitation period. The control group received modern trauma care but no follow-up. Both groups estimated their health-related quality of life two weeks (baseline) and six months after the injury. After six months, estimates of health-related quality of life were generally higher in the intervention group than in the control group. A sub-group analysis found that the differences were most pronounced for the group who had received adequate advice in connection with the telephone follow-up. Of the three road user categories, the motorists gained the greatest benefit from the telephone intervention, with milder problems with regard to pains/difficulties and essential activities. Sub study IV was a health economic study. The calculations were built on the results from study III (n=568). A cost utility analysis was performed, including the costs for the intervention and the QALYs gained. The results showed that the telephone intervention was cost-effective. The total gain in the intervention group was 2.60 QALYs, while the car occupants gained 1.54 QALYs. The cost per QALY gained was 16 000 SEK overall and 8 500 SEK for car occupants. Conclusion: A sensitive caregiver who also provides good information can instil security and trust in the patient. For the purposes of generally improving the quality of care in an A&E, the aim above all should be a short waiting time, but the treatment of minor injuries should also be improved. Access to a supportive nurse who is able to provide advice during the subsequent phase has the potential to improve health-related quality of life in a cost-effective way.

The cost of a road construction over its service life is a function of design, quality of construction as well as maintenance strategies and operations. An optimal life-cycle cost for a road requires evaluations of the above mentioned components. Unfortunately, road designers often neglect a very important aspect, namely, the possibility to perform future maintenance activities. Focus is mainly directed towards other aspects such as investment costs, traffic safety, aesthetic appearance, regional development and environmental effects. This doctoral thesis presents the results of a research project aimed to increase consideration of road maintenance aspects in the planning and design process. The following subgoals were established: Identify the obstacles that prevent adequate consideration of future maintenance during the road planning and design process; and Examine optimisation of life-cycle costs as an approach towards increased efficiency during the road planning and design process. The research project started with a literature review aimed at evaluating the extent to which maintenance aspects are considered during road planning and design as an improvement potential for maintenance efficiency. Efforts made by road authorities to increase efficiency, especially maintenance efficiency, were evaluated. The results indicated that all the evaluated efforts had one thing in common, namely ignorance of the interrelationship between geometrical road design and maintenance as an effective tool to increase maintenance efficiency. Focus has mainly been on improving operating practises and maintenance procedures. This fact might also explain why some efforts to increase maintenance efficiency have been less successful. An investigation was conducted to identify the problems and difficulties, which obstruct due consideration of maintainability during the road planning and design process. A method called “Change Analysis” was used to analyse data collected during interviews with experts in road design and maintenance. The study indicated a complex combination of problems which result in inadequate consideration of maintenance aspects when planning and designing roads. The identified problems were classified into six categories: insufficient consulting, insufficient knowledge, regulations and specifications without consideration of maintenance aspects, insufficient planning and design activities, inadequate organisation and demands from other authorities. Several urgent needs for changes to eliminate these problems were identified. One of the problems identified in the above mentioned study as an obstacle for due consideration of maintenance aspects during road design was the absence of a model for calculating life-cycle costs for roads. Because of this lack of knowledge, the research project focused on implementing a new approach for calculating and analysing life-cycle costs for roads with emphasis on the relationship between road design and road maintainability. Road barriers were chosen as an example. The ambition is to develop this approach to cover other road components at a later stage. A study was conducted to quantify repair rates for barriers and associated repair costs as one of the major maintenance costs for road barriers. A method called “Case Study Research Method” was used to analyse the effect of several factors on barrier repairs costs, such as barrier type, road type, posted speed and seasonal effect. The analyses were based on documented data associated with 1625 repairs conducted in four different geographical regions in Sweden during 2006. A model for calculation of average repair costs per vehicle kilometres was created. Significant differences in the barrier repair costs were found between the studied barrier types. In another study, the injuries associated with road barrier collisions and the corresponding influencing factors were analysed. The analyses in this study were based on documented data from actual barrier collisions between 2005 and 2008 in Sweden. The result was used to calculate the cost for injuries associated with barrier collisions as a part of the socio-economic cost for road barriers. The results showed significant differences in the number of injuries associated with collisions with different barrier types. To calculate and analyse life-cycle costs for road barriers a new approach was developed based on a method called “Activity-based Life-cycle Costing”. By modelling uncertainties, the presented approach gives a possibility to identify and analyse factors crucial for optimising life-cycle costs. The study showed a great potential to increase road maintenance efficiency through road design. It also showed that road components with low investment costs might not be the best choice when including maintenance and socio-economic aspects. The difficulties and problems faced during the collection of data for calculating life-cycle costs for road barriers indicated a great need for improving current data collecting and archiving procedures. The research focused on Swedish road planning and design. However, the conclusions can be applied to other Nordic countries, where weather conditions and road design practices are similar. The general methodological approaches used in this research project may be applied also to other studies.

Varje år skadas många i trafiken. I det fall att den skadelidande och dennes försäkringsbolag inte är överens gällande skadeersättning eller grad av medicinsk invaliditet kan den skadelidande vända sig till Trafikskadenämnden för att få sin sak prövad. Prövningen är kostnadsfri för den skadelidande och avgörs utanför allmän domstol. Men tillvaratas verkligen den skadelidandes intressen på bästa möjliga sätt i Trafikskadenämnden och råder det en rättslig jämvikt mellan konsumenten (den skadelidande) och näringsidkaren (försäkringsbolaget)?Den här uppsatsen ämnar utreda och kartlägga konsumentens intressen i Trafikskadenämnden och huruvida det finns brister och förbättringsmöjligheter i nämndens verksamhet. Att som oförskyllt skadad ställas inför ett sådant omfattande och ensidigt rättsligt arbete som en prövning i nuvarande utformning av Trafikskadenämnden innebär är varken att betraktas som rättvist eller resurseffektivt. / Every year people suffer injuries related to traffic. In the event that the injured party and his or hers insurance company do not agree on the applicable compensation or the degree of medical disability, the injured party can appeal to the Road Traffic Injuries Commission to have their personal case tried. The appeal is free of charge for the injured party and legally processed outside of the civil court system. But is the interest of the injured party safeguarded, and does the commission uphold a legal balance between the consumer (the injured party) and the business operator (insurance company)?This thesis intends to investigate and detect the consumer’s interests in the Road Traffic Injuries Commission and whether there are shortcomings and opportunities for improvement in the commissions function. To be confronted, as an innocent and injured party, with such an extensive and one-sided legal process that the commissions appeal provides, in its current form, is neither to be regarded as legally fair nor resource-efficient.

The cost of a road construction over its service life is a function of design, quality of construction as well as maintenance strategies and operations. An optimal life-cycle cost for a road requires evaluations of the above mentioned components. Unfortunately, road designers often neglect a very important aspect, namely, the possibility to perform future maintenance activities. Focus is mainly directed towards other aspects such as investment costs, traffic safety, aesthetic appearance, regional development and environmental effects. This doctoral thesis presents the results of a research project aimed to increase consideration of road maintenance aspects in the planning and design process. The following subgoals were established: Identify the obstacles that prevent adequate consideration of future maintenance during the road planning and design process; and Examine optimisation of life-cycle costs as an approach towards increased efficiency during the road planning and design process. The research project started with a literature review aimed at evaluating the extent to which maintenance aspects are considered during road planning and design as an improvement potential for maintenance efficiency. Efforts made by road authorities to increase efficiency, especially maintenance efficiency, were evaluated. The results indicated that all the evaluated efforts had one thing in common, namely ignorance of the interrelationship between geometrical road design and maintenance as an effective tool to increase maintenance efficiency. Focus has mainly been on improving operating practises and maintenance procedures. This fact might also explain why some efforts to increase maintenance efficiency have been less successful. An investigation was conducted to identify the problems and difficulties, which obstruct due consideration of maintainability during the road planning and design process. A method called “Change Analysis” was used to analyse data collected during interviews with experts in road design and maintenance. The study indicated a complex combination of problems which result in inadequate consideration of maintenance aspects when planning and designing roads. The identified problems were classified into six categories: insufficient consulting, insufficient knowledge, regulations and specifications without consideration of maintenance aspects, insufficient planning and design activities, inadequate organisation and demands from other authorities. Several urgent needs for changes to eliminate these problems were identified. One of the problems identified in the above mentioned study as an obstacle for due consideration of maintenance aspects during road design was the absence of a model for calculating life-cycle costs for roads. Because of this lack of knowledge, the research project focused on implementing a new approach for calculating and analysing life-cycle costs for roads with emphasis on the relationship between road design and road maintainability. Road barriers were chosen as an example. The ambition is to develop this approach to cover other road components at a later stage. A study was conducted to quantify repair rates for barriers and associated repair costs as one of the major maintenance costs for road barriers. A method called “Case Study Research Method” was used to analyse the effect of several factors on barrier repairs costs, such as barrier type, road type, posted speed and seasonal effect. The analyses were based on documented data associated with 1625 repairs conducted in four different geographical regions in Sweden during 2006. A model for calculation of average repair costs per vehicle kilometres was created. Significant differences in the barrier repair costs were found between the studied barrier types. In another study, the injuries associated with road barrier collisions and the corresponding influencing factors were analysed. The analyses in this study were based on documented data from actual barrier collisions between 2005 and 2008 in Sweden. The result was used to calculate the cost for injuries associated with barrier collisions as a part of the socio-economic cost for road barriers. The results showed significant differences in the number of injuries associated with collisions with different barrier types. To calculate and analyse life-cycle costs for road barriers a new approach was developed based on a method called “Activity-based Life-cycle Costing”. By modelling uncertainties, the presented approach gives a possibility to identify and analyse factors crucial for optimising life-cycle costs. The study showed a great potential to increase road maintenance efficiency through road design. It also showed that road components with low investment costs might not be the best choice when including maintenance and socio-economic aspects. The difficulties and problems faced during the collection of data for calculating life-cycle costs for road barriers indicated a great need for improving current data collecting and archiving procedures. The research focused on Swedish road planning and design. However, the conclusions can be applied to other Nordic countries, where weather conditions and road design practices are similar. The general methodological approaches used in this research project may be applied also to other studies. / <p>QC 20110407</p>

MENVSC / Department of Geography and Geo-Information Sciences / Road transport safety is challenging globally, especially in developing countries, where it affects both road users and governments. The aim of road traffic safety is to ensure a reduction or total eradication of road fatalities and other injuries that are related to road accidents resulting from public road usage. In South Africa, one of the major problems faced by the Department of Roads and Transport is the issue of road traffic accidents. Between 2004 and 2010 the annual road traffic accidents increased to over 500,000 and 28,000 or more are fatal, which has led to serious injuries, as reported by the Department. This study analysed patterns and trends of road traffic injuries and fatalities in Vhembe District Municipality from January 2011 to August 2015. It also mapped road accident hotpots using Getis hotspot analysis and linear referencing in ArcGIS 10.2 spatial statistics extension. The research further established correlation between accidents spots and road design geometry. Factors that are responsible for road traffic accidents leading to fatalities, injuries, and loss of property were also examined. Pedestrian behavioural attitude towards adhering to road safety measures was studied using systematic random sampling, field observation and questionnaires. Finally, the study investigated if there has been any significant reduction in the road traffic injuries and fatalities occurrence rate within the last five years in Vhembe District since the commencement of World Health Organisation; Decade of Action for Road Safety 2011-2020. It was found out that most of the accidents occurred as a result of changes in human social behaviour, negligence and indulgence. The passenger road users category is the worst affected followed by drivers and pedestrians. It was found out that road crashes have decreased by 35% since the commencement of decade of action for road safety. The composition of road traffic injuries and fatalities since 2011 shows a reduction in the numbers of victims recorded. An average of 86 fatalities, 326 serious injuries and 701 minor injuries occurred per annum within the study period. There was high significant value (p  0.05) among all the categories of road users understudied. The differences observed were real and did not occurred by chance for the 5year period (2011 – 2015).