Fall- and collision-related injuries among pedestrians in road traffic environment – A Swedish national register-based study

Amin, Khabat; Skyving, Marie; Bonander, Carl; Krafft, Maria; Nilson, Finn · 2022 · Crossref

DOI: 10.1016/j.jsr.2022.02.007

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Summary

This study investigates the burden of pedestrian injuries in Sweden, specifically addressing the under-recognition of pedestrian fall injuries (PFIs) in road traffic safety statistics. While global road traffic fatalities have declined, injuries among Vulnerable Road Users (VRUs) have not. Traditional definitions of traffic accidents often exclude incidents without a moving vehicle, such as pedestrian falls, leading to a gap in understanding the full scope of pedestrian risk. The authors aimed to quantify the magnitude, demographics, causes, and severity of both collision and fall-related pedestrian injuries compared to other road users, with a specific focus on long-term consequences. The research utilized data from the Swedish Traffic Accident Data Acquisition (STRADA) register, covering the period from 2010 to 2019. The dataset included 361,531 fatalities and injuries reported by emergency hospitals, of which 127,804 involved pedestrians. The study employed comparative analyses using one-way ANOVA and Chi-square tests to assess differences in sex, age, severity, and circumstances between pedestrians and other road users. Injury severity was measured using the Maximum Abbreviated Injury Scale (MAIS) for acute outcomes and the Risk of Permanent Medical Impairment (RPMI) for long-term consequences. The results indicate that pedestrians constitute the largest group of injured road users and the second-largest group of fatalities in Sweden. PFIs accounted for nearly half of all injuries resulting in permanent medical impairment, representing 2.2 times more long-term consequences than injured car occupants. Demographically, females and older adults were significantly overrepresented in PFIs, whereas collision injuries showed a more balanced sex and age distribution. Most PFIs occurred on urban municipal roads during leisure time, with slippery surfaces (ice, snow, gravel) and uneven pavements causing three-quarters of these incidents. In contrast, collision injuries were more evenly distributed across locations and times. Hospital care data revealed that while most PFIs were treated as outpatients, those hospitalized stayed for an average of nearly five days. The study concludes that pedestrian injuries, particularly falls, represent a considerable and persistent public health issue in Sweden, with incidence rates failing to decrease over the study period. The findings highlight that excluding falls from traffic accident definitions obscures the true burden of pedestrian risk, particularly regarding long-term impairment. The authors argue that integrating fall accidents into traffic safety frameworks is essential for accurate data collection and the development of targeted preventive measures, such as improved road maintenance and infrastructure design, to address the specific risk factors associated with pedestrian falls.

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• vru crash typology