The Department of Transport (DOT) is funding a programme of research into the cost of road accidents, with a view to updating the costs which are published each year for appraisal of road and safety schemes. Part of the programme includes research on the long term effects of two of the most disabling road accident injuries: fractures to the upper and lower limbs and soft tissue injury to the cervical spine, or "whiplash". An in-depth study of samples of road accident casualties with these two types of injury is being carried out at the University of Manchester Department of Orthopaedic Surgery, under contract to TRL. Samples of road accident casualties were recruited into the study over an 18 month period during 1987 and 1988, from patients who attended the Accident and Emergency Department of one of three hospitals in Greater Manchester. In total, 413 "whiplash" casualties wre recruited, along with 117 fracture casualties and 9 casualties who had both types of injury. Having been recruited, casualties were interviewed a few days after the accident, and then at six monthly intervals until December 1991, unless they had fully recovered during this period. Interviews covered use of hospital in-patient and out-patient facilities, ambulance service, General Practitioner and District Nurse. Detailed information was collected on time off work and effects on other daily activities, changes in income, claims for compensation and payments of Social Security benefits. This information was used to develop preliminary estimates of the cost to the health service, social services and the individual, in the first year after the accident, for the 423 casualties recruited in the first year of the study; this was reported as Contractor Report CR 212 (see IRRD 830712). The report shows the amount of use made of various services by the full sample of 539 casualties and converts this information into provisional figures for average costs per casualty in the first year and in the second year after the accident. The costs to the individual in terms of loss of income are also quantified, along with the settlement of compensation claims. The results show that costs to the health service declined substantially after the first year, but costs of longer term support in the form of Social Security benefits continued to be prominent in the second year after the accident. This is associated with the fact that many casualties had not recovered from their injuries, and this continuing level of residual disability resulted in them being unable to work.

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