Contributory factors to traffic accident deaths identified at coroner's inquest

BACKGROUND: Road traffic accidents (RTAs) are an important public health problem and the collection of local information is central to successful accident initiatives in a district. As the local coroner is responsible for investigating accidental deaths, the coroner's inquest files are a potentially useful source of information in developing a district strategy to reduce accidents. METHODS: A consecutive series of fatal RTAs occurring within the city of Liverpool (1990-1992) were identified and the inquest records of the city coroner reviewed retrospectively to describe the local pattern of fatal RTAs and identify contributory factors. RESULTS: A total of 95 deaths were reviewed. Deaths predominantly involved pedestrians (72) and private cars (70), on roads where the speed limit was 30 m.p.h. (75), often on the main arterial roads of the city (53). Important contributory factors included alcohol consumption by the fatality (31), unsafe driving (31), unlit street lighting at night (16), and pedestrians failing to look (12). Both alcohol consumption and unsafe driving prominently involved younger adult males. More than two-thirds (64/95) of deaths had one or more contributory factors identifiable from inquest records. CONCLUSIONS: Coroner inquest records provide a useful source of information to identify opportunities and priorities for preventing fatal RTAs in a district. The subsequent accident strategy for Liverpool, part of the City Health Plan, advocates a co-ordinated approach that includes engineering measures to reduce vehicle speeds and protect pedestrians, measures to address driver attitudes, and the enforcement of current legislation in relation to alcohol and speeding.