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SOME CAUSES OF

THE CARNAGE ON THE ROADS*FROM A CORRESPONDENT

MANY remedies have been advocated for the carnageon the roads, but comparatively little has been writtenon the more basal question of aetiology. It is customaryto blame the car-driver and to demand a more stringentdriving test or heavier penalties against sinners. As

doctors, we should look more closely at other removablecauses such as bad lighting, lack of road signs, and themany hazards of the highway. Let us take two examples:Lighting.-A man is driving his car westward from

Shepherd’s Bush to High Wycombe. From Westway untilhe reaches Horn Lane he glides along a safe well-lighteddouble track. At that spot, without warning, he is suddenlyplunged into semi-darkness on a dangerous winding singletrack until he reaches Park Royal. The lighting then

improves, but the single track threatens him as far as Green-ford. This piece of highway treachery is unfair to thedriver and dangerous to the public.Road Signs.-Again, the driver who has only a bowing

acquaintance with the main roads leading out of Londongets little help from the authorities. From time to timehe may be told the destination of roads that slink away tothe right or left, but he is never by any chance given thename of the street along which he is actually travelling.Now and again, at great risk to himself and other road users,he must squint up at some building in the hope of decipheringa street name. In cities like New York the authorities tellhim at every cross-roads (a) the name of the street on whichhe is driving and (b) the name (or number) of the cross street.He is thus able to keep his eye on the road and drive safely.

THE DRIVING TEST

We ought also to call for an impartial examination ofthe driving test itself. There is a deplorable lack ofstatistical information on the examiners’ finding,though we are told that the rate of failures under testconditions is about 36%. The regulations were- intro-duced in a praiseworthy attempt to improve standards ofdriving, and to increase the margin of safety on the.roads. Are they achieving their object Is the systemhelpful to applicants as an education, or is it merelybecoming a tyranny of tricks and rules In the car-

driving test as it stands today the victim suffers manydisadvantages. (1) He is seen by only one examiner,for a very short period, perhaps in a strange town.(2) He is probably nervous and ill at ease, and thereforeliable to errors that he would not normally commit.(3) He has not previously had an opportunity of drivingalone, and so lacks the confidence of personal experience.(4) If he fails he must either not drive at all or returnto the leading-strings for a whole month-or risk a

fine of 10s. and a month’s imprisonment. And lastly(5), the examiner knows nothing about the candidate’sbackground or training.No doubt the Ministry of Transport has conducted

operational research into these matters, and it would beuseful to know something of the results. The followingpoints would be instructive :

1. The proportion of applicants passed at each attempt,area by area.

2. A comparison of the results over several years.3. An analysis of the results of first and subsequent tests

with reference to the candidate’s age, sex, and possiblyoccupation.

4. The main reasons for failure put forward by examiners.5. The pass-rate at different times of the day and on

different days of the week. -

6. The difference, if any, between wet days and finedays.

* See Dr. C. A. Learoyd’s article of Feb. 25 (p. 367).

7. The results of presenting the same candidate to variousexaminers.

8. A psychological study of the success or failure of

applicants, in relation to simple personality features.

Psychology of the Driver -

An investigation of the candidate’s personality mightbe particularly interesting. Thus, broadly, one wouldexpect the extrovert to make a good showing at hisfirst test. He concerns himself primarily with objects,facts, and persons in his immediate environment, and hetends to be practical in affairs. On the other hand, hesoon ignores the lessons learnt, because he is essentiallyopportunist. He shows no great concern for others.The introvert is more concerned with his own impulsesthan with direct response to varying outward sensations.He shows up badly, as a rule, in " snap " tests, but hisdiscrimination and judgment are sounder than thesewould suggest.A psychological study would be misleading without an

exploration of the broad no-man’s-land between normalityand the neuroses. The obsessional may do splendidlyin an examination, if he concentrates for the time beingon the object of his desire ; but in the long run he willbe unreliable as a driver. The anxious type, on the con-trary, almost invariably does badly under test conditionsbut is more likely to be conscientious and considerateon the road. Unfortunately the anxiety tends to beprogressively exaggerated by repeated examinations, andthe unhappy victim is deprived by the regulations ofhis one chance of success-an opportunity to gain,confidence through practice by himself.

The TenderfootA further question we should ask is simply this :

what proportion of automobile accidents are associatedwith recently tested motor-car drivers ‘ The figures.might be further broken down and analysed.

LIGHT-FLASHERS

It is curious that apparently no-one has referred to the,new nightmare of discourtesy-light flashing at cross-

roads in the city.. The other day we had to attendmedically to a woman who had collided with a lamp.standard on the pavement. She had been temporarilyblinded by a selfish driver who persisted in flashing hisheadlights on and off to save himself the trouble of

slowing down. This cruel and dangerous malpracticeis on the increase, and should be forbidden.

Public Health

Mortality in Northern IrelandIN Northern Ireland during 1949 the infant mortality

(45 per 1000 live births), the maternal mortality (1-27per 1000 live births), and the death-rate from tuber-culosis (59 per 100,000) were the lowest ever recorded..The birth-rate, at 21-4 per 1000 population, showeda small decrease but was still above the average recordedfor the ten years before the war. Last year 24 personsdied of cancer for every 10 who died of tuberculosis ;but there has been no increase in deaths from cancer inthe past seven years.

Q Fever in GermanyThe Office of the Surgeon-General, U.S. Army, has

reported that 90 civilian cases of Q fever have occurredat Zusenhausen (population 1500), near Heidelberg.Most cases have been mild, although 1 death has beenreported. The diagnosis has been confirmed by theFourth Medical Laboratory, Heidelberg.The source of the epidemic has not yet been ascertained

by the German health agencies. Presumably Zusenhausenrepresents a new area in Germany for this disease.

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