to the editor: I would like to thank Dr. Butler and colleagues for the article on post-traumatic stress reactions following motor vehicular trauma.¹ Those who work in injury care and/or injury control know that the long-term effects of trauma are often occult and diverse in presentation. The National Center for Healthcare Statistics within the Centers for Disease Control and Prevention continually reminds us that trauma is the leading cause of death in persons between one and 44 years of age in the United States.² Dr. Butler's article and the accompanying patient education sheet are timely and needed.

However, I would like to encourage the readers of American Family Physician and Dr. Butler and colleagues to adopt the more acceptable substitutions for the word “accident.” There is a concentrated effort on the part of professionals who care for trauma patients to avoid the word “accident” in their verbal and written communications. More than just a semantic exercise, choosing the words “crash,” “incident,” “collision,” or even “wreck” over “accident” allows one to describe a traumatic event without implying that it occurs serendipitously. Every traffic crash has a cause and effect. Implying that crashes and the subsequent injuries are “luck,” “acts of God” or “accidents” hampers efforts to lower the incidence of injury-related death and disability in the United States. Please consider an editorial review standard that disallows the word “accident” to describe events such as motor vehicle collision that lead to trauma.