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Although the total number of crashes decreased across all districts except Clutha, 19 people still died on Otago roads in 2010 and 954 were injured, the latest analysis from the New Zealand Transport Agency shows.
The social cost of these crashes came to $219.5 million, which included $94.7 million from Dunedin.
The estimated costs included loss of life or quality of life, lowered output due to injuries, medical and rehabilitation costs, legal and court costs, and property damage.
New-look, more detailed crash analyses for all 13 regions in New Zealand were released this week.
The figures showed that compared with 2009, last year there were fewer road crashes in which people were injured in Otago in the Waitaki, Queenstown-Lakes, Central Otago and Dunedin districts, and an increase of one crash in the Clutha district.
The new reports identify key road safety issues and risks in each district.
They showed the most common factors in road crashes in which someone was injured in Otago were poor observation (not checking properly), poor handling of vehicles (for example, losing control while braking) and poor judgement (such as misjudging the speed of others).
Most injury crashes happened on a bend, when either a driver of a single car lost control and went off the road, or vehicles collided.
Dunedin had the highest rate of injury crashes with 543 people injured in 406 crashes last year.
Urban intersections were identified as the greatest area of concern: nearly half of all injury crashes in Dunedin since 2006 happened at one.
Outside Dunedin, the Clutha district had the most injury crashes, with 135 people injured in 85 crashes, mostly on state highways. The most (six) died in crashes on roads in the Waitaki district, with only one fatality on Central Otago's roads.
The agency said it hoped the more detailed regional crash analysis reports would be useful for territorial authorities wishing to monitor trends and track progress on road safety initiatives in their district.
The emphasis of the reports, which include crash data for the most recent five-year period and will be updated annually, was on identifying risks and trends so trauma from crashes as well as the number of crashes could be reduced, an agency spokesman said.