Injuries resulting from motor-vehicle crashes are the leading cause of death for persons of every age from 6 through 33 years (1) and have a large economic impact on the general population. This report summarizes an analysis by the National Highway Traffic Safety Administration (NHTSA) of costs for total and alcohol-related motor-vehicle crashes during 1990 (2) and estimates the economic impact for police-reported and unreported crashes.

Fatal crash data were obtained from NHTSA's Fatal Accident Reporting System, and nonfatal crash data from NHTSA's National Accident Sampling System and the Federal Highway Administration (2). Data for injuries not reported to police were based on a trend-adjusted comparison of police-reported data with data from the National Health Interview Survey. Cost estimates were based on data from the Federal Highway Administration (3) adjusted to 1990 dollars and on 1990 estimates of property damage, injuries, and fatalities. Costs for motor-vehicle crashes included direct costs (e.g., medical care, property damage, and insurance administration) and indirect costs (e.g., loss of earnings and lost household productivity). Injury costs were based on the maximum injury sustained (MAIS) using the Abbreviated Injury Scale -- a standardized system on a scale of 1 (least severe) to 6 (most severe) for categorizing injury type and quantifying severity based on immediate threat to life (4). Noninjury costs (e.g., property damage and travel delay on roadways) were included to provide a comprehensive estimate of crash costs. Sources for estimates included special cost studies (5), the Detailed Claims Information file of the National Council on Compensation Insurance, police and emergency services reports, Federal Highway Administration and Bureau of Motor Carrier Safety data, claims data from the Insurance Information Institute, and average hourly wage and fringe benefits data from the U.S. Department of Labor.

Motor-vehicle crashes during 1990 accounted for 44,531 fatalities, 5.4 million nonfatal injuries, and 28 million damaged vehicles, and an estimated total cost of $137.5 billion (Table 1). Major sources for cost were property damage ($45.7 billion {33%}), productivity losses in the workplace ($39.8 billion {29%}), medical-care expenses (13.9 billion {10%}), and losses related to household productivity ($10.8 billion {8%}).

The greatest unit cost was associated with fatalities * -- approximately $702,000 per fatality; per-person costs for the most critical nonfatal injuries (MAIS 5) were approximately $589,000 -- 84% of the cost per fatality. The predominant cost component for fatalities was productivity losses at home and in the workplace from premature death (80%) (Figure 1). For MAIS 4-5 (severe and critical) injuries, the predominant costs were related to lifetime medical care (40%) (Figure 1).

In 1990, crashes that involved any alcohol (i.e., blood alcohol concentration {BAC} level greater than or equal to 0.01 g/dL) cost $46.1 billion (Table 2) and represented approximately 33% of all economic costs attributed to motor-vehicle crashes. Of this amount, $37.5 billion (81%) reflected crashes in which a driver or pedestrian was legally intoxicated (i.e., a BAC of at least 0.10 g/dL in most states). Alcohol use was disproportionately involved in crashes associated with death or critical injury, accounting for an estimated 50% of total incidence and 55% of total cost for these crashes. In contrast, alcohol was involved in approximately 15% of noninjury-related crashes.

Reported by: LJ Blincoe, BM Faigin, Office of Plans and Policy, National Highway Traffic Safety Administration. Unintentional Injuries Section, Epidemiology Br, National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: The economic impact of motor-vehicle crashes during 1990 was approximately 2.5% of the gross domestic product in the United States. Although most motor-vehicle crashes involved no injury, crashes resulting in injuries and fatalities accounted for three fourths of all crash costs. Nearly 30% of the first-year medical costs of hospitalized persons injured in a motor-vehicle crash in the United States is paid by federal, state, and local government sources such as Medicaid and Medicare (6). Prevention of motor-vehicle crashes represents an opportunity for substantial reductions in health-care costs in the public and private sectors.

The economic costs of motor-vehicle crashes described in this report exceed other estimates (5,7) because they include property damage costs; costs related to uninjured occupants; consumer price increases; changes in the bases for calculating costs incurred in future years; legal/court, employer/workplace, and travel delay costs; and cost data from sources not previously available. In addition, the number of nonfatal injuries and crashes exceeded those reported annually by NHTSA (8) because they included estimates of unreported crashes; during 1990, approximately 22% of the 5.4 million persons incurring nonfatal motor-vehicle injuries did not file a police report.

The need for more effective approaches to preventing motor-vehicle crashes is underscored by the large number of premature deaths and injuries resulting from crashes, the high rate of alcohol involvement, and the enormous economic impact on the general population. Public health strategies to prevent these costs include the development of new measures (e.g., crash-avoidance vehicle technology), more effective application of proven approaches (e.g., increasing occupant protection through use of safety belts, child safety seats, and air bags), and reduction of alcohol-impaired driving and other risky driving practices (9,10).

Further information on cost estimates of motor-vehicle crashes is available in The Economic Cost of Motor Vehicle Crashes, 1990 (2). Copies are available through the Distribution Office, Room 6117, NHTSA, 400 7th Street, SW, Washington, DC 20590.

References

1. National Highway Traffic Safety Administration. 1992 Traffic

fatality facts. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis, 1993.

2. Blincoe LJ, Faigin BM. The economic cost of motor vehicle crashes, 1990. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1992; report no. DOT-HS-807-876.

3. Miller TR. The costs of highway crashes. Washington, DC: US Department of Transportation, Federal Highway Administration, 1991; report no. FHWA-RD-91-055.

4. Committee on Injury Scaling, American Association for Automotive Medicine. Abbreviated injury scale, 1985 revision. Arlington Heights, Illinois: American Association for Automotive Medicine, 1985.

5. CDC. Cost of injury -- United States: a report to Congress, 1989. MMWR 1989;38:743-6.

6. Harris JS. Source of payment for the medical cost of motor vehicle injuries in the United States, 1990. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1992; report no. DOT-HS-807-800.

7. Blincoe LJ, Luchter S. The economic cost to society of motor vehicle accidents. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1983; report no. DOT-HS-806-34.

8. National Highway Traffic Safety Administration. General estimates system, 1990: a review of information on police-reported traffic crashes in the United States. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1991; report no. DOT-HS-807-781.

9. CDC. Position papers from the Third National Injury Control Conference: setting the national agenda for injury control in the 1990s -- executive summaries. MMWR 1992;41(no. RR-6):1-4. 10. National Highway Traffic Safety Administration. Moving America safely: priority plan -- NHTSA's activities through 1994. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1992; report no. DOT-HS-807-928.

• Includes MAIS 6 injuries, which are so severe they are untreatable and virtually unsurvivable.

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