The death toll figure was routinely crossed out and increased.

Appin Road is a busy state road that every day caters to thousands of vehicles, including many trucks carrying freight between Wollongong and Campbelltown.

In the early hours of Wednesday January 27, yet another life was lost on the notorious road after a head-on collision involving a car and a coal truck.

A 40-year old man from Minto in Sydney's south-west died at the scene of the crash after his Honda Civic collided with a truck just before 4.30am.

Appin Road is a 37-kilometre stretch of road that is a major link road between south western Sydney at Campbelltown and the coast of Wollongong, via the Appin township.  

The road extends across three Local Government Areas: Campbelltown City Council, Wollondilly Shire Council and Wollongong City Council.

The 2014 safety review of the road published by Roads and Maritime Services and NSW Centre for Road Safety assessed a 27-kilometre length of the road between Kellerman Drive, Rosemeadow, to the Princes Highway at Bulli Tops.

Appin Road is a single carriageway state road and is predominantly one lane in each direction, with some sections of two lanes providing overtaking opportunities.

There are a number of formal rest area sites along the road for heavy vehicles.

Important developments along the stretch of road include large residential properties between Rosemeadow and Appin, the Inghams Chicken Farm, recently developed Appin Valley, Appin Township, Appin Colliery and West Cliff Colliery.  

Between Appin and Bulli the road is predominantly surrounded by bushland.

There are two significant bridges in the southern section of Appin Road, shown to be the site of the majority of serious accidents, over the Georges River and Loddon Creek.

Since the year 2000, there have been only three years when there were no fatalities from vehicle accidents on Appin Road.

According to Transport NSW, 23 people have died in 22 serious crashes on the arterial road from 2000 to 2015.

Of these crashes, nine were head-on collisions and eight involved a vehicle leaving the roadway and hitting an object, such as a tree.  

Last week's fatal crash was near the Kings Fall Bridge on a stretch of the road infamous for serious accidents.

A safety review of the road published in 2014 by Roads and Maritime Services and NSW Centre for Road Safety found that a 16-kilometre stretch after the Appin township to the Princes Highway, where there are "significant curves" in the road, was the deadliest.

The review identified four "crash clusters" within this section, where there had been five fatal crashes in five years.

Along this length there is no median strip, and for the most part has only one lane in each direction.

Tributes of flowers, crosses, photos and soft toys have been left tied to trees lining the road in memory of loved ones who have died in accidents on the thoroughfare.

"When these accidents happen my family and I only ever see the need for more safety on that road," said Blake Connor, who lost his sister, Ashleigh to a fatal car crash on Appin Road in 2011.

21-year-old Ashleigh Connor was a talented striker for the Illawarra Stingrays football team who had represented her sport on the world stage, playing for Australia in the Young Matildas squad.

"Sometimes I wondered how I could have had such a talented daughter", said her father, John in a news article published after her death.  

Ashleigh was driving home on Appin Road one rainy night in July after a team meeting at Fairy Meadow's Fraternity Club when her car veered off road and crashed into a tree.

The wreckage of her vehicle was found early the next morning.

"Heaven must have needed a striker," wrote former Matildas captain Melissa Barbieri on Ashleigh's Facebook page.

"It has been extremely difficult for our family," said Blake Connor.

"It is not something that you can ever adjust to. You never do move on, you just have to learn how to live without that person."

Four and a half years after Ashleigh's death, her memory remains strong within the community.

Late last year her soccer club organised a "dedication day" in Ashleigh's honour and established a permanent memorial for the young striker at her old training grounds.

"That was a beautiful thing for us all," said Blake Connor. "It showed us that she is never far from everyone's thoughts."

NSW Minister for Roads Duncan Gay said speed and fatigue are the "key killers" on Appin Road.

"No matter how much work we do, unless people take personal responsibility, sadly we could see more tragedies occur," Mr Gay said.

Between 2000 and 2015, more than half of the fatal crashes were linked to excessive speed.

The speed limit on Appin Road from the Appin township to the Princes Highway was reduced by 10km/h to be 90km/h in February 2015 and traffic police regularly patrol the road.

A police spokesman described Appin Road as a "key road" and said that "road users need to give due regard to other traffic and drive to the conditions".  

The local member for Keira, Ryan Park acknowledged the actions of drivers were serious problems but said there were numerous issues with the road itself.

"No doubt driver error is a problem, but that road is very unforgiving so there's not a lot of area where you can get yourself out of a difficult situation."

Mr Park said the lack of median strips and shoulder room either side of the road were key issues.  

"If someone makes a mistake there is not a lot of shoulder room, there are not a lot of dual carriageway sections, not a lot of it is separated by median barriers.

"That  becomes problematic particularly because it is used by people travelling and commuting in the early hours of the morning or late at night," Mr Park said.

In addition to previous safety improvements made to the road, work began last week on a $6 million project to realign two curves about four kilometres west of the Princes Highway identified as key "crash clusters".

According to a spokesperson for Roads and Maritime Services, there are further plans to improve lighting and install more warning signs along the road later this year.

Mr Park described the project as "very positive", but said more should be done to improve safety for increasing numbers of drivers using the road.

"It can't just be a one-off.  The $6 million allocation is only going to be one drop in the ocean to what is really needed.

"You're looking at tens of millions of dollars and that investment needs to take place for a number of reasons – not just to make it safer but to improve the efficiency of people travelling along that road because South Western Sydney is going to become one of the key growth hubs of NSW.

"At the moment, that road is simply too notorious."

The local member for Campbelltown, Greg Warren, said Appin Road needs to be recognised as part of a "broader network issue".

"You can't just look at a road as being the problem.

"Before we go shovelling millions of dollars into something, let's look at why people are on that road, where they are going and what can be done alternatively," Mr Warren said.  

He has advocated for the enhancement of the Menangle Spring Farm link road as a solution to reducing the volume of traffic on Appin Road.       

For the Connor family, any work being done to improve safety on Appin Road is a good sign.

"That they are straightening out those curves – one of them is actually Ashleigh's accident site, makes us realise that they are taking into consideration the dangers that this road presents," said Blake Connor.

He said he and his family would like to see better lighting and guard rails installed to prevent further accidents on this road.