The person-days is our analysis unit for incidence calculation and it provides the estimate of impact/burden of road traffic events. From that perspective, multiple crashes with one person involved

in each are equivalent to one crash involving several employees. We base our recommendations for improved road safety practices on this ranking. However, it is unfortunately not possible to directly compare our incidence rates with existing statistics, which typically provide rates of crashes or deaths per number of motor vehicles, or per 100,000 persons.10 In comparison with the latest available World Health Organization (WHO) www.selleckchem.com/products/MDV3100.html statistics for the year 2009, none of our top 10 countries only were also ranked among the top 10 on the corresponding WHO country ranking measured by traffic deaths per 100,000 persons.10 This may also be a reflection of a different travel pattern for business travelers than for the general population. In a literature review awaiting the Sydney 2000 Olympics, Wilks identified from several studies that tourists, compared with the local residents, were at an increased risk

on the roads. Particular risk factors included unfamiliarity isocitrate dehydrogenase inhibitor with the roads, driving on the left side, poor adherence to traffic rules, and alcohol abuse. Being jet lagged and dehydrated from an international flight would also be a risk factor.11 However, a review of all deaths among Peace Corps volunteers (PCV) between 1984 and 2003 did show a different pattern.12 PCV are exposed to unique risks, but these risks have become significantly less

fatal over the past 20 Metalloexopeptidase years and compared to the US population. There is obviously a difference of risk between tourists with a more relaxed lifestyle and professional business travelers backed up by an international organization. Although the risk for pedestrians represents an important area of road safety risk for travelers, we did not address it in our study at this time. In the road safety literature, risk factors are typically attributed to the driver, the vehicle, and the environment.13 On the basis of the comments from our travelers, drivers seem to be a major factor. Lack of driver attention, aggressive driving, speeding, and lack of concentration including tiredness and cell phone usage were mentioned in 42% of the crashes. This is slightly less than the findings of Rumar, who in 1985 found that 57% of the crashes were due solely to errors of the drivers.14 The use of alcohol and other drugs by drivers often leads to car crashes, and is in many countries poorly controlled.15 While drivers of Bank-owned vehicles in general get high marks, taxis can come with poorly rested drivers and substandard vehicles. Seventy percent of the reported crashes took place in taxis, although it is not clear what proportion of travel occurred in these vehicles.