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The major cause of serious disability or loss of life is not infections. Trauma caused by injuries, principally that suffered in motor vehicle crashes, is the leading cause of death and disability in both developed and developing countries worldwide. Motor vehicle crashes result from a variety of factors, including inadequate roadway design, inattention to pedestrians and pedal-cyclists, or impairment due to alcohol or drug use; all these factors are preventable or can be abated. Defensive driving is an important preventive measure. When driving or riding, insist on a vehicle equipped with safety belts and where available, use them. When available, also insist on a vehicle equipped with air bags and anti-lock brakes. As a high proportion of crashes occur at night when returning from "social events", avoid non-essential night driving, alcohol, and riding with persons who are under the influence of alcohol or drugs. Pedestrian, bicycle, and motorcycle travel are often dangerous and helmet use is imperative for bicycle and motorcycle travel.

Fire injuries are also a significant cause of injuries and death -- inquire about whether hotels have smoke detectors and sprinkler systems, and do not smoke in bed. Travelers may wish to bring their own smoke detectors with them. Always look for a primary and alternative escape route in rooms in which you are meeting or staying. Look for improperly vented heating devices which may cause carbon monoxide poisoning. Remember to escape a fire by crawling low under smoke.

Other major causes of injury trauma include drowning and drug reactions. Protection against potentially hazardous drugs is nonexistent in some countries. Do not buy medications "over the counter" unless you are familiar with the product.

Travelers should also be aware of the potential for violence-related injuries. Risk for assault or terrorist attack varies from country to country; heed advice from residents and tour guides about areas to be avoided, going out at night, and going out alone. Do not fight attackers.

Excerpted from:U. S. Department of Health and Human Services, Centers for Disease Control and Prevention. HHS Publication No. (CDC) 94-8280. June, 1994. pg. 172

Your Armchair Advisor says "At the very least make sure you have evacuation insurance - especially when traveling to undeveloped regions. Emergency evacuation may not be covered under your health insurance policy. If you desire, you can get evacuation insurance as a stand-alone separate policy. You might also consider a major medical policy to protect you while you are traveling. "

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