Injury Prevention The major cause of serious disability or loss of life in foreign countries is not infectious disease; it is trauma, usually the result of motor vehicle accidents. Such accidents may result from many factors, including inadequate roadways, hazardous conditions, poor maintenance of vehicles, inexperienced drivers, inattention to pedestrians and cyclists, and the use of alcohol or drugs. Many of these factors can be eliminated or minimized by preventive measures. Defensive driving is an important measure. Insist on vehicles with safety belts, and consider the potential advantages of airbags and anti-lock brakes. Avoid non-essential night driving, alcohol, and riding with persons who are under the influence of alcohol or drugs. Use a helmet for bicycle or motorcycle travel. Fires are also a major cause of injury and death in foreign countries. Never smoke in bed. Look for hotels with smoke detectors and sprinkler systems. Have a plan for escape in case of fire, and remember to escape a fire by crawling low under smoke. Also be aware that improperly vented heating devices may cause carbon monoxide poisoning. Other potential risks include drowning and drug reactions. Do not buy over-the-counter medications in foreign countries 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. Government authorities do not recommend fighting attackers and, if you are confronted, they advise giving up your valuables.