RT Accidents mortality in Italy: a population-based study in Piedmont on Vulnerable Road Users

Abstract

Abstract Background Among the largest Italian Regions, Piedmont (Northern Italy) had in 2017 a crude rate of road traffic accidents (RTA) deaths greater than the national average. RTA injuries remain a leading cause of injury deaths in Italy. Among them in both Piedmont and Italy many victims are vulnerable road users (VRU): pedestrians, cyclists and users of motorcycles or motorpeds. The study was aimed to describe their mechanisms of injury. Methods Observational study of the resident population in Piedmont from 2003 to 2015. Transportation Injuries (ICD-10: V01-V99) were considered, because of their greater comparability rate in bridge coding studies. A number of 5,185 RTA deaths was observed. Role, type of vehicle of the victim and collision were studied. Results Piedmont in 2017 had a RTA mortality rate (6.35 deaths per 100,000 inhabitants) greater than Italy (IRR = 1.13, 95% CI: 1.00 - 1.29; p < 0.02), 48.4% of the victims were VRU similarly to national data (49.8%). In the period the proportion of VRU on RTA deaths steadily increased from 25.6% in 2003 to 49.1% in 2015, in a significant way (z = 2.79; p = 0.005), because in a context of marked reduction of RTA mortality (-54.5%), the regional trend for VRU shows only a slight decrease (-12,6%). The VRU were: pedestrians (47.0%), motorized two-wheels users (37.4%) and cyclists (15.6%). Among pedestrians 63.9% deaths were caused by collisions with mainly automobiles (82.1%) and heavy vehicles (12.7%). In case of collision the prevalent causes of death were head injuries (41.5%) and multi-trauma (31.8%). Similar patterns were observed for cyclists, while in motorcyclists 56.5% of deaths were due to loss of control or fixed object. Conclusions VRU injuries remain a public health and social concern. Yet despite their extent, this problem is still not adequately considered in public health prevention programs. The observed mechanisms of injury evidence the importance to enhance the protection of VRU in road traffic circulation. Key messages In Italy, vulnerable road users are becoming a major group among road traffic injury deaths, because they not follow the general trend of large decrease of RTA injuries. Largest VRU group are pedestrians such as cyclists they are hit by cars or heavy vehicles with major trauma, in the motorized two-wheels loss of control and collision with fixed object are important.