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The EU research project SafetyCube pays specific attention to serious road injuries, defined as nonfatal road traffic casualties with an injury severity level of MAIS3+. By means of surveys, information was collected on current practices concerning the estimation of the number of MAIS3+ casualties and on costs related to serious road injuries in different European countries. Moreover, the effect of differences in practices on the estimated number of MAIS3+ casualties was investigated by applying different methods to the same data. Finally, by means of a literature review, analysis of additional case studies, and burden of injury calculations, health impacts of serious road injuries were investigated. This paper presents six main lessons learned from these activities. Practices concerning the estimation of the number of MAIS3+ casualties differ between countries; some countries apply correction factors to police data, other countries use hospital data, and a third group of countries uses linked police and hospital data. Practices also differ concerning the selection of MAIS3+ road traffic injuries within hospital data. Differences in methodology appear to affect the MAIS3+ estimate. Therefore, one should be careful when comparing figures from different countries. The SafetyCube guidelines can support further harmonization. It is important to reduce the number of serious road injuries because injuries can have major impacts on a casualty’s life and pose a burden to society. About 75% of the MAIS3+ road traffic casualties are not fully recovered 3 years postcrash. Moreover, serious road injuries cost countries up to 2.7% of their gross domestic product.

Introduction Costs related to road crashes represent an important societal burden. Additionally they constitute an essential input variable to assess the cost efficiency of road safety measures. While most attention is usually spent on costs related to fatal crashes, this paper focuses on costs related to serious injuries. Method A review of these costs is presented based on different data sets and methods. Results A survey collecting crash cost estimates in European countries shows considerable variation in the costs related to serious injuries. The reported cost per serious injury varies between €28,205 and €975,074 and the total costs related to serious injuries vary between 0.04% and 2.7% of a country’s GDP. The applied methodology to estimate human costs appears to have a large influence. Other potential explanations are the applied definition for seriously injured victims, the registration procedure of crashes with serious injuries and the cost components that are included. Detailed analyses of medical costs and production loss that are based on country-specific datasets show the importance of assessing medical costs on the long term and taking into account the variation of these costs for different subgroups of traffic victims. A comparison of approaches to estimate monetary values for human costs shows that most countries use the Willingness To Pay method. While having a sound theoretical background, this method is rather limited in the specification of injuries. The use of Quality Adjusted Life Years gives the possibility to provide values for a larger diversity of injury types.

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