In 2019, the World Health Organization’s (WHO) World Report on Vision emphasized the prevalence of poor vision around the world, stating that at least 2.2 billion people around the world have substantial vision impairments. These numbers are staggering for several reasons, including the fact that many of these people share the world’s roads as drivers and pedestrians.
We recently interviewed one of the study’s authors Dr. Luis Montoro González, Full Professor of Road Safety at the University of Valencia and President of Honor of the Spanish Foundation for Road Safety (FESVIAL), to understand the importance of this work and its role in helping to create safer roads around the world.
Good vision has only recently been included in the conversation on road safety, so the message is changing. What does the current dialogue around vision and road safety (safer mobility) look like?
LMG: Road safety as a topic has been in the global spotlight for some time now. We’re all familiar with campaigns that encourage the wearing of seat belts and discourage the use of alcohol or cell phones while driving. Vehicle manufacturers have also done their part to make cars safer, and cities have created dedicated lanes for pedestrians and bikes on the road.
While the topic of vision on the road has not been at the forefront of the road safety conversation, it needs to be. In our report, we mention that “the latest Global Status Report on Road Safety, published by the World Health Organization (WHO) in December 2018, highlights that road traffic fatalities have grown worldwide, up to 1.35 million in a year, plus 50 million road users have been injured as a consequence of road traffic crashes.” We go on to say that “these ‘accidents’ are not really accidental yet have become the leading cause of non-natural death for people aged between 5 and 29 years.”
Times are changing and recent progress has been made. In 2020, the United Nations formulated recommendations to governments for enhancing national road systems in the framework of its 2021-2030 2nd UN Decade of Action for Road Safety Plan. This finally included a call to ensure that road users around the world have good vision.
Why do you think that vision has not been included in the global road safety discussion until recently?
LMG: One of the reasons is that there is still limited research on the impact of good vision on reducing road traffic accidents. Research is key to convincing governments that policy change is needed. In our report, we conclude that there is a connection between good vision and traffic accidents. It’s our hope that the additional proof point will highlight the need for further legislation requiring regular eye exams for drivers or as part of driver license requirements, especially as the global population ages.
What were the key findings of the report?
LMG: According to our research, we concluded that between 5% and 20% of traffic crashes are directly or indirectly caused or enhanced by a road user’s visual problems and that these crashes are preventable through good policymaking and healthcare-related actions.
Were there any conclusions that surprised you?
LMG: From our perspective, the results are not very surprising, as other research has shown the connection between traffic crashes and poor vision. For example, in 1993, a study in the United States conducted by the Research Council found that up to 50% of traffic crashes involving older drivers are related to vision defects.
The key word to note in the stat from our research is “preventable.” These accidents are avoidable, and the outcomes could have been much different had those involved had good vision.
In the report, you mention three actions that you recommend – changing laws, increasing awareness and furthering research. How can other vision advocates come alongside you and partner to further this cause?
LMG: Advocates have a big role to play. It is critically important that they use their voices to advocate for more research on the topic. Without concise and relevant data, change will never happen.
Advocates at the national government level have a crucial role to play. Adding more frequent vision checks for driver licenses around the world could make a big difference, in terms of reducing loss of life and injuries, reducing healthcare costs and increasing economic productivity for societies. It’s a simple solution that can make a difference for all who use the world’s roads.
Vision advocates can also make a difference wherever they do their work. For example, if they work to ensure better vision for children, their work will pay off when those young people are drivers and can see well due to eye exams they had in school. If advocates are working to improve access to vision for women, they would also be creating a significant movement toward safer mobility. The female entrepreneur who can see well to run her local business is the same woman who can see well when she navigates the roads and take her wares to market. Not to mention, she often guides the healthcare decisions of the family and the greater community.
How can we reduce the obvious research gap related to vision and safer mobility?
LMG: Although it might sound self-evident, the first step is a widespread misconception about empirical research aimed at studying, in depth, the relationships between vision and safe mobility. Since (by common sense) one could assume the majority of the population is already aware of the safety-related importance of vision, at first glance, vision is often assumed as a topic rarely producing big headlines.
This is, however, a false belief of those who do not understand that in science nothing can be "taken for granted". Indeed, and from experience, I can assure you that every time we perform a new study highlighting the role of vision on road safety, we find something worthy and useful for strengthening both visual health and road safety.
Also, although evidence-based research implies extensive costs and technical challenges, what is invested in studies on vision and road safety today is very minimal. I hope this work, and the sponsorship of private sector players like Essilor, encourages not only other researchers, but new funders to invest in scientific developments with a truly selfless and community-focused purpose.
If your research leads others around the world into action, what specifically do you hope would result from it?
LMG: As I mentioned earlier, our work in this area always yields new (and better) results. Every time we conduct another study, we are able to explain more, and in a better way, the influence of vision on road safety, that was previously unknown to science. This desire to "update" the current knowledge has allowed us to move relatively fast in this matter and could encourage many other stakeholders to take action and get more involved.
For now, we will highlight the practical applications and new challenges resulting from each of our studies, so that it is easier to put them into practice. There is still much to do, but this is only the beginning of a long and fruitful journey.
Dr. Luis Montoro González, Ph.D. is the Full Professor (Faculty of Psychology) of Road Safety at the University of Valencia. He is also the President of Honor at the Spanish Road Safety Foundation (FESVIAL). As one of the most qualified experts in traffic safety and security in Spain, Dr. Montoro leads the Human Factor and Road Safety (FACTHUM.lab) research group at the Research Institute on Traffic and Road Safety (INTRAS), University of Valencia.