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A unexpected development has encouraged me to return to a theme in my first letter (JTM 2000;28:,p. 3). That letter dealt with how objections to the word accident played a role in renaming our organization the International Traffic Medicine Association (ITMA), replacing the earlier International Association for Accident and Traffic Medicine (IAATM). The unexpected development was a change in the policy of the British Medical Journal announced in an editorial by Ronald M. Davis and Barry Pless in the 2 June 2001 issue of the journal titled ?BMJ bans accidents. Accidents are not unpredictable.? (BMJ 2001;322:1321-2) The editorial starts: For many years safety officials and public health authorities have discouraged use of the word ?accident? when it refers to injuries or the events that produce them. An accident is often understood to be unpredictable?a chance occurrence or an ?act of God??and therefore unavoidable. However, most injuries and their precipitating events are predictable and preventable. That is why the BMJ has decided to ban the word accident. In an editorial in the BMJ in 1993 Evans explained why ?motor vehicle crash? is an appropriate expression but ?motor vehicle accident? is not: ?The word crash indicates in a simple factual way what is observed, while accident seems to suggest in addition a general explanation of why it occurred without any evidence to support such an explanation.? Evans also argued that ?accident? is inappropriate in reference to medical errors (as in medical accidents) and that ?its use in medical settings continues to mislead.? The reference is to my editorial ?Medical accidents: no such thing?? (BMJ 1993;307:1438-9). Precise terminology is crucial in scientific thinking. There are all too many cases in the technical literature in which authors compromise their credibility by the thoughtless use of non-objective language that is more appropriate for politics than science. For example, measured quantities, such as the percent of drivers wearing safety belts, do not ?improve?. Quantities get bigger or smaller, they do not get better or worse. Countries containing few vehicles per million population are central to many studies. The term ?less-motorized countries? is a straightforward way to refer to such countries. Yet all too often the designation ?developing countries? is used without justification or explanation. A common indication of development is growth of Gross Domestic Product. By this measure, the countries of North America and Western Europe are developing, while many less motorized countries are not. Technical writing should strive for simple value-free terms that convey with the least ambiguity and verbosity the intended concept. The evolution to a more precise and agreed terminology is important as we strive together to make traffic medicine a more recognized and influential scientific discipline addressing one of the world?s major public health problems. In technical writing on the subject we should strive for the objective clarity that is taken for granted in the traditional sciences. Leonard Evans
President, ITMA
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Rev. 24-Jan-2003
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