6.2.3: Case Study- The Haddon Matrix and Motor Vehicle Accidents
William Haddon Jr. was a prominent accident and prevention researcher in the 1960’s and 70’s, and became the first director of the National Highway Traffic Safety Administration (Associated Press, 1985). He developed a matrix using the epidemiological triangle and integrating the concepts of primary, secondary, and tertiary prevention (discussed in Chapter 3). Applying these concepts to an automobile crash, we can create an epidemiological triangle with points for human factors, vehicle factors, and environmental factors. Thus, there are factors that influence the likelihood and severity of injuries at phases before, during, and after the crash - which Haddon titled pre-event, event, and post-event. An example Haddon matrix can be seen in Table 6.1.
Table \(PageIndex(1)\): Example of a Haddon Matrix. Adapted from Contributors to Wikimedia projects. (2022, April 9). Haddon Matrix . Wikipedia .
|
Phase |
Human Factors |
Vehicle Factors |
Environmental Factors |
|---|---|---|---|
|
Pre-Crash |
Information Attitudes Impairment Police Enforcement Attention |
Vehicle condition Lighting Braking Tires Speed control |
Road design Speed limits Pedestrian accommodations Weather |
|
Crash |
Impaired driving Seatbelt wearing |
Airbags Seatbelts Other safety devices |
Guard rails/road safety barriers |
|
Post-Crash |
First aid skills EMS response |
Access to passengers Fire risk |
Rescue facilities/hospitals Traffic |
At each phase there are strategies that could be applied to adjust these different factors in order to improve safety and reduce injuries. For example, educational campaigns can remind people of the risks of texting while driving, and rideshare and taxi service availability can reduce the incidence of impaired people getting behind the wheel - which could address human factors pre-crash (perhaps preventing a crash from occurring at all). Vehicle factors could begovernment regulations requiring seat belts, airbags, windshield wipers, and antilock brakes, or the crash-test safety ratings on that particular make and model could affect both the ability of the driver to avoid a crash and how much impact is absorbed by the driver and passengers if there is one. Environmental factors could be addressed with the design of the roads, including median barriers (to separate opposing traffic), speed limits, traffic signals, and pedestrian bridges or walkways. And the access to an efficient emergency response system along with the distance to a hospital could affect how well crash injuries can be treated, and lives can be saved.
Public health initiatives can focus on one particular factor in the triangle or perhaps several at once. But in order to understand these problems and factors, we need data - and gathering and analyzing data is at the core of epidemiological work.