Injuries to Pedestrians and Bicyclists: An Analysis Based on Hospital Emergency Department Data

NHTSA · 1999 · ROSA P / United States. Federal Highway Administration

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Summary

This study addresses the significant underreporting of pedestrian and bicyclist injuries in traditional police crash data, which captures only motor vehicle collisions on public roadways. Motivated by the need to inform safety countermeasures under federal initiatives like ISTEA, the research aims to characterize the full spectrum of injury events, including non-roadway collisions and non-motor vehicle incidents such as falls. The study specifically investigates the frequency of these "missed" cases, the role of alcohol in injuries, and seeks to estimate total injury numbers by integrating multiple data sources. The methodology combined prospective data collection with retrospective analysis across three states: California, New York, and North Carolina. Researchers collected detailed data from eight hospital emergency departments over a one-year period using specialized survey forms. This primary data was supplemented by statewide hospital discharge records and state motor vehicle crash files. The study categorized injuries into four quadrants based on location (roadway vs. non-roadway) and involvement (motor vehicle vs. non-motor vehicle), allowing for a comprehensive comparison between medical records and police reports. The findings confirm that official crash statistics severely underestimate injury prevalence. Literature review and study data indicate that police reports capture only 20% to 82% of hospital-reported cases, with lower ratios for bicyclists and those receiving only emergency department treatment. A substantial portion of bicyclist injuries result from bicycle-only events rather than motor vehicle collisions; for instance, previous studies cited in the report show 60–70% of hospitalized bicyclists were injured in non-motor vehicle events. Similarly, non-roadway events, such as those in driveways or parking lots, account for a significant share of injuries, particularly among young pedestrians. The study also highlights that alcohol use is a relevant factor in both pedestrian and bicyclist injuries, with specific distributions analyzed by event type and demographic characteristics. The significance of this research lies in its demonstration that relying solely on police crash data provides an incomplete picture of traffic safety risks. By revealing the high prevalence of non-roadway and non-motor vehicle injuries, the study argues for broader data collection methods to guide effective program development. The integration of hospital emergency department and discharge data offers a more accurate estimate of the injury burden, supporting the federal goal of reducing pedestrian and bicyclist injuries by 10%. The findings underscore the need for safety interventions that address environments beyond public roadways, including private properties and recreational areas.

Key finding

Official police crash reports significantly underestimate the number of injured pedestrians and bicyclists, with hospital data revealing a substantial volume of injuries from non-roadway locations and non-motor vehicle events that are typically excluded from state traffic statistics.

Methodology

dataset

Provenance

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Topics

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• vru crash typology
• incidence prevalence
• cyclist safety
• demographic disparities

Information type

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• Empirical Findings: crash risk outcomes