Pedestrian Accidents Research Articles

A review of geriatric injuries at a major trauma centre in South Africa.

Trauma in South Africa (SA) has been referred to as a malignant epidemic, but the impact of trauma on the elderly has tended to be overlooked. To address this deficit by focusing on trauma victims aged ≥65 years. All patients aged ≥65 years who were admitted to Grey's Hospital, Pietermaritzburg, SA, following trauma between December 2012 and January 2019 were reviewed. Over the 6-year study period, a total of 281 patients aged ≥65 years were admitted to Grey's Hospital following trauma. There were 150 males (53.4%) and 97 females (34.5%). The sex of 34 patients was unknown. The average age was 72 years (range 65 - 97). There were 226 cases of blunt trauma, 42 cases of penetrating trauma (including two incidents of impalement following blunt trauma) and 15cases of other types of trauma. The most common causes of blunt trauma were accidental falls (n=76), motor vehicle accidents (n=46), pedestrian vehicle accidents (n=32) and falls from a height (n=23). Gunshot wounds (n=22) and knife wounds (n=14) were the most common forms of penetrating trauma. Other trauma mainly comprised dog bites (n=6) and snakebites (n=6). There were 72 incidents of assault (25.6% of total cases). The majority of assaults were committed by a single perpetrator, and the perpetrator was frequently known to the victim. There were no significant differences in the proportions of penetrating, blunt and other trauma injuries between males and females. A total of 44 patients (15.7%) required surgical intervention, and 41 patients (14.6%) experienced complications during their hospitalisation. Respiratory, renal and cardiac complications were most frequent, and 5 patients had a cardiac arrest. Seven experienced acute kidney injury. Seventeen patients (6.0%) required intensive care unit admission and 5 (1.8%) required ventilation. Patients stayed in hospital for an average of 2.96 days (range 0 - 39). Of the patients, 241 (85.8%) survived, 32 (11.4%) died and 8 (2.9%) had an unknown outcome. Geriatric trauma in SA is relatively rare, but will increase as the population ages. There is a high incidence of assault as a mechanism, highlighting the fact that elderly people are a vulnerable group. Managing these patients is challenging and is associated with significant morbidity and mortality.

TRAUMATIC PELVIC FRACTURES HOSPITALIZED IN KASR AL-AINY HOSPITAL IN 2018: A RETROSPECTIVE STUDY

ABSTRACT: Major pelvic fractures are predominantly observed when there is a high-energy transfer to the patient such as following road traffic collision, pedestrian accident, fall from height, or crush injury. Less serious pelvic fractures may occur with low-energy transfer events, particularly in the elderly. Objectives: The aim of the current study is to statistically assess the prevalence, common causes, management and outcome of pelvic fracture cases admitted to Kasr Al-Ainy hospital through the year 2018. Subjects and methods: The data presented in this study were obtained from the bureau of statistics at Kasr Al-Ainy hospital. One hundred ninety six cases with traumatic pelvic fracture were admitted to Kasr Al-Ainy hospital during the one year period study from January 2018 to December 2018. Results: the incidence of traumatic pelvic fractures in the present study was higher in males, urban areas and day time. The age group 21-40 was associated with the higher percentage of traumatic pelvic fractures and the mean age was 35 years. Road traffic accidents were the commonest cause followed by fall from height. The higher incidence of cases showed multiple pelvic fractures and the higher percentage of cases was treated surgically. Improvement was the major outcome while death was associated with the old age group above 61 years. Conclusion and recommendations: there is a need to decrease the number of road traffic accidents and greater precautions should be taken against the risks of fall from height. Old age group should be managed with special care.

Predictors of fatal outcomes in pedestrian accidents in Tabriz Metropolis of Iran: Application of PLS-DA method

Objectives: Road traffic deaths in walking pedestrians are a global public health problem. Considering that in Iran pedestrians have a high proportion of deaths caused by traffic accidents, the objective of the present study was to investigate mortality rate and related factors of fatal injury in pedestrian crashes in Tabriz Metropolis of Iran as the largest and most populous city of the northwest of Iran.Methods: The design of this study is case-control based on police and Forensic Medicine Organization data. All registered fatal pedestrian crashes in Tabriz Metropolis from 2014 to 2015 (146 cases) were included in the study as the case group. Also, 292 pedestrians (the ratio of cases to controls was 1:2) with non-fatal crashes were considered as the control group. Due to high dimensional data and multicollinearity issue, Partial least squares discriminant analysis (PLS-DA) was used for data analysis. Importance of the variables was determined by the VIP (Variable Importance in the Projection) index. Performance of the model was assessed by using training and test set validation method. The area under the ROC curve (AUC) and classification error rates were calculated for the test set. R software version 3.5.1 (mixOmcs packages) was used for data analysis.Results: According to the results of PLS-DA, the most important variables related to fatal outcome in pedestrian crashes with VIP > 1 were: pedestrian age (positive effect), type of vehicle (light machinery with a negative effect), kind of vehicle plate (private plate with a negative effect), season of accident occurrence (winter season with a positive effect), type of driver’s licenses (Class A with a positive effect), pedestrian gender (male with a positive effect) and Fault of Pedestrian (At-fault with a positive effect). The overall accuracy for the fitted model and AUC were 0.77 and 0.79, respectively.Conclusions: The results show that predictors of a fatal outcome in pedestrian accidents in Tabriz can be attributed to the pedestrian characteristics (which notably account for differences in vulnerability in case of an accident), the car and driver features, and weather (which may all notably influence the amount of energy involved in the collision, through the car mass, speed, and conditions delaying the braking response or reducing the braking effectiveness). Regarding the statistical method, the PLS-DA is a powerful method which can be used to analyze high dimension data with multicollinearity issue.

Relationship between age and injury severity in traffic accidents involving elderly pedestrians.

ObjectiveThis study aimed to examine whether injury severity differs with respect to age among elderly pedestrians involved in traffic accidents and identify factors affecting injury severity.MethodsUsing emergency department-based injury in-depth surveillance data, we analyzed the data of patients aged ≥60 years who were victims of pedestrian traffic accidents during 2011 to 2016. The pedestrians’ ages were divided into 5-year age strata beginning at 60 years. In a multivariate analysis, injury severity was classified as severe to critical or mild to moderate.ResultsThe analysis included 10,449 patients. All age groups had a female predominance, and accidents most frequently occurred during the early morning. Multivariate analyses revealed that compared to the 60 to 64 years group, the odds ratios for incurring a severe injury were 1.18 (95% confidence interval [CI], 1.02 to 1.37) for the 65 to 69 years group, 1.42 (95% CI, 1.23 to 1.64) for the 70 to 74 years group, 1.70 (95% CI, 1.45 to 1.98) for the 75 to 79 years group, and 1.83 (95% CI, 1.56 to 2.15) for the ≥80 years group.ConclusionIn this study of emergency department-based data, we found that injury severity increased with age among elderly victims of traffic accidents. Furthermore, injury severity varied with respect to sex, time and location of the accident, and type of vehicle involved. Therefore, measures intended to reduce and prevent traffic accidents involving elderly pedestrians should consider these findings.

Factors and Their Correlation with Injury Severity of Elderly Pedestrian Traffic Accidents

Purpose: No previous study has assessed elderly pedestrian traffic accidents based on a nationwide database. This study aimed to help primary physicians who examine patients in emergency departments to determine and make prompt and accurate treatment decisions. Methods: This study used data from the Emergency Department-based Injury Indepth Surveillance from 2013 to 2017, managed by the Korea Centers for Disease Control and Prevention. Pedestrians aged ≥65 years were included, and using multivariate logistic regression multiple factors were analyzed to determine their relationship with injury severity. Results: Of 227,695 subjects, 6,498 were included, of whom 2,065 (31.8%) were severely injured. There were more female than male patients in all severity groups. Most accidents occurred in the afternoon and on general roads. In the multivariate analysis, the odds ratio (OR) of injury severity for male pedestrians was 1.165 (95% confidence interval: 1.034-1.313, p=0.012). Older age of patients and the use of ambulances were associated with greater injury severity. The accident time affected the degree of injury severity; i.e., compared to dawn, injury severity increased in the morning (OR: 1.246, p=0.047) and decreased at night (OR: 0.678, p<0.001). A significant difference was noted in the correlation between the type of vehicle causing the accident and the accident severity; i.e., motorcycle accidents had lower severity than bicycle accidents (OR: 0.582, p=0.047). Conclusions: Injury severity was correlated with sex, age, transportation to the ED, TA onset time, and type of vehicle. The study results suggest that injury severity may be positively reflected in initial assessments and overall integrated treatments by physicians and in the related policies.

The influence of alcohol on the outcome of trauma patients: a matched-pair analysis of the TraumaRegister DGU®.

In the diagnosis and treatment of trauma patients, numerous individual and trauma-related factors must be considered, all of which may influence the outcome. Although alcohol exposure is a major risk factor for an accident, its influence on the outcome is unclear. This matched-pair analysis investigates the hypothesis that alcohol has no negative impact on the outcome of trauma patients. In a retrospective matched-pair analysis of the multi-centre database of the TraumaRegister DGU® patients with a maximum Abbreviated Injury Scale (MAIS) of 3 or greater from the years 2015 and 2016 with an alcohol level ≥ 0.5‰ were compared to patients with a measured alcohol level of 0.0‰. The patients were matched according to age, gender, AIS body regions (head, thorax, abdomen, pelvis/extremities) and survival presumption (Revised Injury Severity Classification Score (RISC) II the TraumaRegister ervals). After matching, a total of 834 patients were enrolled, with 417 patients in group with positive blood alcohol levels (BAL +) with a median alcohol level of 1.82‰and 417 patients in the negative-alcohol group (BAL -). As a mechanism of injury, the BAL + group showed more often penetrating injuries, pedestrian accidents and low energy falls compared to car and motorcycle accidents in the BAL - group. BAL + patients were significantly less sedated (BAL -: 66.7% vs. BAL + : 56.2%, p = 0.002), less frequently transported by rescue helicopter, were more frequently hypotensive (BAL-: 42 patients (10.3%) vs. BAL + : 61 patients (15.2%), p = 0.045, Table2) and exhibited lower base excess levels associated with an acidotic metabolic status compared to sober patients (acidosis: BAL-: 24 patients (6.1%) vs. BAL + : 61 patients (17.2%), p < 0.001). There was no difference regarding in-hospital complications, length of stay or mortality rate. Our data demonstrate that alcohol exposure in trauma patients has no impact on complication or mortality rates. On the other hand, there are initially clear differences in the mechanism of injury, sedation, mode of transport and the acid-base balance.

Technical evaluation of the pedestrians’ model on the roads within the city (case study: Gilan province)

Since the adverse effects of each accident is subordinated to its direct severity, in studies of the traffic safety, has been tried a lot for providing the severity models to identify the severity factors of the adverse effects of the accidents. In this research, the modeling of the pedestrian accidents severity has been evaluated by using the dual logistic regression and three methods. In the number one and two methods, the relationship between the independent variables and the dependent variables respectively was investigated separately (Enter method) and integrated in the model (forward stepwise method). In the third method, first the primary independent variables have been reduced to the fewer variables by using a multi variables statistical method as the analysis to factors method, the variables and then the new variables relationship with the dependent variable, was analyzed by using the logistic regression. The dependent variable in the following models is the pedestrian accidents severity in two injury and fatal categories.

Effects of Road Infrastructure on Pedestrian Safety

Pedestrians represent more than 30% of all of Poland’s road traffic fatalities. This is much higher than the EU average (about 20%). Pedestrian accidents are usually the result of a complex situation and a number of contributing factors involving road users, the road and roadside and the vehicle. Pedestrian accidents are caused by road user error (drivers and pedestrians) and wrong planning and design. Poorly maintained road infrastructure is also a very frequent cause. The objective of the work was to identify risks for pedestrians that involve road infrastructure and roadside and to define how selected elements of geometry and traffic layout affect driver behaviour (speed on approaching pedestrian crossings). The results have helped to formulate recommendations on pedestrian crossing design. The research included an analysis of 2013-2017 statistics to identify the circumstances and causes of pedestrian accidents. Field work at about 2, 000 unsignalized pedestrian crossings was the basis for assessing the safety of these crossings. Assessment criteria were selected and a safety classification was made with specific recommendations made for possible treatments. More field work was designed to measure speeds near pedestrian crossings in three cases: no pedestrians in the crossing area, a pedestrian is approaching a crossing, a pedestrian is waiting to cross the road. The study was conducted in different areas (city, transit roads passing through small towns, non-built-up areas) for different cross-sections (one carriageway and two lanes – 1x2, two carriageways with two or three lanes each – 2x2, 2x3, one carriageway and four lanes – 1x4). The study also looked at speed limits – 50 and 70 km/h. The share of drivers giving way to pedestrians waiting to cross was also assessed. Pedestrians were surveyed and asked about how safe they feel crossing the road. The survey also asked drivers about driver behaviour and use of speed management measures. Statistical analyses show the circumstances and causes of pedestrian accidents. These include driving across a pedestrian crossing illegally, pedestrians stepping onto the road abruptly, night-time, excessive speed and others. Pedestrian crossings are the site of more than 30% pedestrian fatalities which shows the need for treatments. By assessing the hazards caused by road infrastructure near and at pedestrian crossings, the following hazards could be identified: limited sight-distance, poor illumination, excessive speed and no means of speed management, wrong geometry (length of crossing, number of traffic lanes), technical condition of the road and signage. Speed tests near pedestrian crossings show that some 40% of drivers do not observe the speed limits in built-up areas (especially on sections of transit roads passing through small towns and on dual carriageways in urban areas) and 30% do not observe the speed limits on rural roads.

Pedestrian Road Accident Index for Municipalities: The Portuguese Case

Portuguese road traffic accidents statistics show that the number of accidents with fatalities and serious injuries has in general decreased in recent years. However, the number of accidents involving pedestrians is still high when compared with those observed in other countries of the European Union. In order to assess this problem, an index of pedestrian road traffic accidents for municipalities that could be used in decision-making about pedestrian safety measures is proposed. The use of absolute values of accidents involving pedestrians (running over) does not allow itself a reliable comparison of pedestrian safety level between municipalities. In this sense, the approach proposed uses the information available in the Portuguese database PORDATA to calculate a municipal index that takes into account the degree of exposure of pedestrians to accident, based on national and municipal resident population annual growth rates and number of pedestrian’s casualties. This index allows to identify the municipalities with unfavourable deviation to national numbers of road accidents involving pedestrians (per 10000 inhabitants), supporting the plan and allocation of human and economic resources for the diagnosis, definition and implementation of safety measures. The results obtained can be visualized in a GIS for a more comprehensive comparison between municipalities. The analyses performed for Portugal showed that, in general, municipalities with higher resident population annual growth rates, located mostly along the coastline and in more consolidated urban areas, tend to present better index values, which points to the need to intervene in less consolidated areas.

ANALYSES OF PEDESTRIAN’S HEAD-TO-WINDSHIELD IMPACT BIOMECHANICAL RESPONSES AND HEAD INJURIES USING A HEAD FINITE ELEMENT MODEL

Head injuries in the vehicle crashes or pedestrian accidents can usually cause death or permanent disabilities, and head injuries resulting from the impact of car windshields remain a major problem. Anatomically, more realistic head models are required to more accurately document and evaluate the head-to-windshield impact responses and head injuries. The current study developed a head finite element model and carried out various simulations to investigate the head-to-windshield impact biomechanical responses and assess the head injuries. First, a 50th percentile three-dimensional finite element head model was developed and validated by using previously published cadaver experimental data. Then, the biomechanical responses were predicted under a head-to-windshield impact at different impact velocities (10, 12, and15[Formula: see text]m/s) and different inclination angles of the windshield (35∘, 40∘, and 45∘). Finally, head injuries were investigated through examining various injury parameters. The results indicated that the contact force, the acceleration, the intracranial pressure, the deformation of the skull, and the negative pressure rose when the impact velocity and the inclination angles increased. Thus, the vehicle impact velocity and the inclination angle of the windshield greatly affect the severity of the resulting injuries on pedestrians’ heads, with the severity increasing with the impact velocity and windshield inclination angle.

Same Day Surgical Intervention Dramatically Minimizes Complication Occurrence and Optimizes Perioperative Outcomes for Central Cord Syndrome

Abstract INTRODUCTION As surgery is increasingly recommended for patients with neurologic deterioration secondary to central cord syndrome (CCS), it's important to investigate the relationship between time to surgery and patient outcomes. The merits of early vs delayed surgical treatment remain controversial in the literature. METHODS CCS patients were isolated in NIS database 2005 to 2013. Operative patients were grouped by time to intervention: same day, 1-d delay, 2, 3, 4 to 7, 8 to 14, and &gt;14 d. ANOVA and chi-squared tests compared demographics, Charlson Comorbidity (CCI) scores, length of stay (LOS), discharge status, periop complications, and charges across patient groups. Controlling for age, CCI, and concurrent traumatic fractures, binary logistic regression assessed surgical timing associated with increased odds of periop complication, using same-day as reference group (OR [95% CI]). RESULTS Included: 6734 CSS patients (59 ± 16 yr, 26% F, CCI: 1.2 ± 1.6). Rate of surgical treatment was 64.1%, with rates of surgery increasing from 2005 (50%) to 2013 (73%, P &lt; .001). The most common injury mechanisms were falls (30%) and pedestrian accidents (7%). Of patients that underwent surgery, 52.0% underwent fusion (62% 2-3 levels, 33% 8-levels, 1% 9 + levels), 30% discectomy, and 14% other decompression of the spinal canal. Same-day patients had the lowest LOS, total charges, and the highest rates of home discharge. Same-day patients showed a trend of lower periop sepsis neurologic complications. Patients delayed &gt;14 d to surgery had increased odds of periop cardiac (7.0 [1.6-30.0]) and infection (6.1 [2.2-16.3]) complications. Timing groups beyond 3-d showed increased odds of VTE: 4 to 7 d (3.0 [1.6-5.5]), 8 to 14 d (3.0 [1.4-6.3]), 14 + d (5.6 [2.3-13.6]). CONCLUSION CCS patients undergoing surgery the same day as admission had lower odds of complication, hospital charges, and higher rates of home discharge than patients that experienced a delay to operation. Delay &gt;14 d to surgery was associated with inferior outcomes, like increased odds of cardiac complication and infection.

Are management decisions in critical patients changed with use of hemodynamic parameters from transpulmonary thermodilution technique?

The assessment of hemodynamic variables is a mainstay in the management of critically ill patients. Hemodynamic variables may help physicians to choose among use of a vasopressor, an inotropic agent, or discontinuation of drugs. In this study, we aimed to investigate the usefulness of advanced hemodynamic variables in clinical decision-making. Surveys regarding the case were administered to 25 surgeons working in nationally designated trauma centers or on trauma teams, using a voting system at a medical conference. The patient was a 67-year-old male with a crush injury of the left leg after a pedestrian traffic accident, who had aggravated pulmonary edema after leg amputation. Three clinical situations were given and the decision choices were: immediately after amputation, in 8 hours, and on the second day after amputation. Three kinds of variables from hemodynamic monitoring systems were provided for each clinical situation: conventional hemodynamic variables, including central venous pressure; variables from pulse contour analysis (PCA) [cardiac output (CO), stroke volume index, stroke volume variation (SVV), and systemic vascular resistance index); and variables from transpulmonary thermodilution (TPTD) technique (global ejection fraction and extravascular lung water index). The changes in decisions according to each provided hemodynamic variable were investigated and analyzed. The advanced hemodynamic parameters were considered to have a decisive effect on choosing vasopressors and inotropic agents. The decision was changed in 88% (22/25) of physicians using variables from the advanced monitoring systems. Among them, 82% (18/22) of physicians chose hemodynamic variables from the TPTD technique as their reason for change regarding management of a patient with severe pulmonary edema. Advanced monitoring systems might be helpful in decision-making for critically ill patients. Multiple parameters and trends in change could be more important than a single value. Clinicians should select the system most appropriate according to its advantages and limitations, and interpret the variables obtained correctly.

Spectrum of multi-detector computed tomography imaging findings of thoracic vascular injuries secondary to blunt chest trauma: Correlation with vascular intervention and patient outcomes.

BackgroundThoracic vascular injuries following blunt chest trauma are the second leading cause of trauma-related deaths. Multi-detector computed tomography (MDCT) is the imaging modality of choice in detecting these injuries.ObjectivesTo determine the spectrum of vascular injuries detected on MDCT imaging in patients who sustained blunt chest trauma, and to assess the various types of management options and patient outcomes.MethodWe retrospectively reviewed archived medical records of polytrauma patients who presented with blunt chest trauma and confirmed vascular injury on MDCT and vascular intervention images between May 2015 and August 2018 at Inkosi Albert Luthuli Central Hospital.ResultsThirty-nine patients with vascular injury findings were analysed. The injury spectrum comprised: 15 aortic injuries (AI), 19 non-aortic injuries (NAI), 4 combined (AI and NAI) and 1 aorto-venous injury. A majority of males (69%) with an overall mean age of 39 years constituted the study cohort. The commonest injury mechanisms included motor vehicle collisions (61%) and pedestrian accidents (28%); the remaining 11% were shared amongst motorbike accidents or falling from a moving train or a height. The subclavian artery (36%) was the most common anatomical location in the NAI and the frequent imaging finding was vessel occlusion (55%). The most common imaging findings in AI were the indirect signs (20.5%) followed by a grade III injury (15.4%). Six patients with a grade III AI were successfully managed with endovascular repair.ConclusionA thorough knowledge of blunt vascular injury spectrums and imaging manifestations is critical when interpreting MDCT scans. Awareness of the mechanism of injury will trigger a high index of suspicion and probe a search for a vascular injury.

Spatial analysis of mortality rate of pedestrian accidents in Iran during 2012–2013

Objectives: Considering the high mortality rate of pedestrians in traffic accidents in Iran, the present study aimed to determine the high-risk and low-risk areas of accidents resulting in pedestrian deaths and the spatial analysis of their mortality rates.Methods: This cross-sectional study included 4,371 deceased pedestrians reported by the Legal Medicine Organization in Iran from March 2012 to March 2013. For spatial analysis, the collected data were entered into ArcGIS software version 10.2 and a spatial map of the mortality rate was drawn according to the distribution of data in the provinces. Using this software, high-risk and low-risk areas were identified by calculating the spatial autocorrelation of the data. The Moran’s index of road accident patterns was surveyed and high-risk and low-risk points were identified using the local Getis index.Results: The age-standardized incidence rate was 6.8 per 100,000. After analyzing the data using ArcGIS software, the local Moran’s index showed a cluster pattern with a high mortality rate in 3 provinces of Mazandaran, Gilan, and Qazvin. In identifying high-risk and low-risk points, the local Getis index showed 3 hot spots with a confidence interval of 99% in Qom, Qazvin, and Mazandaran and 5 hot spots with a 95% confidence interval in Markazi, Tehran, Zanjan, Gilan, and Golestan provinces.Conclusions: According to the cluster pattern of accidents in the 3 provinces and the presence of hot spots in 9 provinces, it is necessary to identify factors that increase the risk of death in the study provinces in order to reduce the mortality rate among pedestrians due to traffic accidents. Therefore, to reduce the pedestrian mortality rate, especially in high-risk provinces, some studies need to be conducted to determine the risk factors in pedestrian mortality.

Evaluation of the Benefits of Traffic Calming on Vehicle Speed Reduction

Vehicle speed is one of the main risk factors for road traffic safety. To increase the level of road safety, especially in urban areas, measures must be implemented to reduce vehicle speed. The installation of calming measures on a road network is systematically planned way to reduce driving speeds. This paper studies the effectiveness in terms of speed reduction of three types of traffic calming measures: 1) speed table, 2) chicane, and 3) road narrowing. The speed analyses regard a series of traffic calming measures located in urban contexts of Catania Province (Italy). For each of these traffic calming measures, experimental investigations were carried out relating to the measurement of speed. The study has shown that the speed tables represent the measure of traffic calming that guarantees the greatest conditioning on speed (it is also possible to halve the average speed). Even the chicanes have a significant impact on reducing speed, as well as the speed tables (average speed is reduced by up to 50%), while road narrowing allows maximum reductions in average speed of around 35%. Furthermore, all three traffic calming measures have resulted in a reduction of accidents always greater than 30%. In the case of speed tables, the reduction in accidents exceeds even 40%. The consequences of road accidents are also mitigated thanks to the traffic calming interventions considered. The reduction of injured people is between 32% (road narrowing) and 50% (chicane). The speed tables involve a reduction of almost 40% of injured people while fatal accidents are completely eliminated. Finally, it has been observed that the reduction in pedestrian injuries is between 33% (road narrowing) and 50% (speed tables). In the case of the chicane the reduction of injured pedestrians is 40%. The pedestrian fatal accidents in the road section in which the speed tables were subsequently installed have been reduced to zero.

지하주차장 보행안전 평가 프레임워크 개발 및 적용

Objective: This study aims to develop a pedestrian safety assessment model for underground parking facilities that comprehensively measure the pedestrian safety level of an underground parking facility.BRBRBackground: Although underground parking spaces have many potential risks that can cause pedestrian accidents, assessment frameworks that enable to comprehensively measure and monitor the risk levels of underground parking facilities have not been widely discussed in the literature. In this regard, it is necessary to develop a safety assessment framework that can objectively and quantitatively capture the safety level in an underground parking facility.BRBRMethod: 381 indicators that are associated with general pedestrian safety were extracted from the extant literature first. Then, these indicators were streamlined and standardized based on the importance of each indicator. Finally, a total of ten identified major indicators with sub-indicators and three safety factors categorizing these indicators were derived as a basis of a safety assessment framework. A weighted average scoring system using Analytic Hierarchy Process (AHP) was employed for the indicators measured in a Likert scale and their associated factors to quantify the overall safety level. The proposed framework was applied to a case study of a Korean university.BRBRResults: The results showed the overall safety level of the undergraduate parking facility at the university is in a range of

Factors related to the increasing number of seriously injured cyclists and pedestrians in a Swedish urban region 2003-17.

BackgroundThe number of seriously injured unprotected road users has increased during implementation of a road safety policy Vision Zero. The aim of the study is to identify factors associated with the increase in serious injuries among cyclists and pedestrians (even single pedestrian accidents) that occurred in an urban road space in a Swedish region 2003–17. The urban road space includes roads, pavements and tracks for walking and cycling.MethodsData were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) and NVDB (National Road Database). Descriptive statistics and logistic regression with odds ratios for sex, age and part of road space were assessed.ResultsThe number of seriously injured cyclists and pedestrians more than doubled from 2003 to 2017, with the greatest increase for pedestrians. Older age increased the probability of serious injury since 2012 for the group ≥ 80 years and since 2015 for the group 65–79 years. No significant effect of sex. Most injuries occur in areas not transformed by Vision Zero.ConclusionsAn increasing number of elderly persons in the generation born in the 1940s and increased life expectancy are important factors. There is a need to increase road safety measures that also promote active mobility.

Relationships Between External Factors and Pedestrian Accident Blackspots – A Case Study of the City of Zagreb

Traffic accidents represent a social, health and political challenge in every country. Urban environments are characterized by intense traffic flows on the network, where different conditions resulting in interactions between motorised and non-motorised transport constantly occur, potentially increasing the risk of accidents. Although road accidents are considered as random events in space and time, a highly detailed analysis may establish correlations between road accidents and external factors (road infrastructure, traffic conditions, weather conditions, land use). This paper considers the impact of external factors on road accidents involving pedestrians in the City of Zagreb, which required an analysis of accident blackspots. The research conducted in this paper puts an emphasis on relations between external factors and accident blackspots involving pedestrians. The results can be used in planning pedestrian infrastructure and improving road safety.

Design and performance evaluation of acoustic vehicle-to-pedestrian communication system

There is a greater risk of vehicle–pedestrian accidents when vehicles are traveling at low speeds. To cope with this problem, acoustic vehicle-to-pedestrian communication that can measure relative speed between vehicle and pedestrian is proposed. The proposed system is easy to implement on both the vehicle and pedestrian side, and will promote improved traffic safety. The proposed system is affected by noise, Doppler shift, fading, delay spread, and Doppler spread, and uses an orthogonal frequency division multiplexing signal, error correcting code, frequency diversity, and null subcarrier to counteract these effects. The performance of the proposed system was evaluated in outdoor experiments using real vehicles. In a line-of-sight environment, the proposed system measured relative speed and communicated without bit error at a distance of 40 m with a transmitter moving at about 2.78 m s−1 and a stationary receiver. In a non-line-of-sight environment, the proposed system measured relative speed and communicated without bit error at a 9 m distance between transmitter and receiver, which is a sufficient distance to prevent vehicle–pedestrian accidents.

Situational characteristics of fatal pedestrian accidents involving vehicles traveling at low speeds in Japan

Objective: This study aimed to investigate the situational characteristics of fatal pedestrian accidents involving vehicles traveling at low speeds in Japan. We focused on vehicles with 4 or more wheels. Such characteristics included daytime or nighttime conditions, road type, vehicle behaviors preceding the accident, and vehicle impact locations.Methods: Pedestrian fatality data on vehicle–pedestrian accidents were obtained from the Institute for Traffic Accident Research and Data Analysis of Japan (ITARDA) from 2005 to 2014. Nine vehicle classifications were considered: Trucks with gross vehicle weight (GVW) ≥7.5 tons and <7.5 tons, buses, box vans, minivans, sport utility vehicles (SUVs), sedans, light passenger cars (LPCs), and light cargo vans (LCVs). We compared the situational daytime or nighttime conditions, road type, vehicle behaviors preceding the accident, and vehicle impact locations for accident-involved vehicles traveling at low and higher speeds across all vehicle types.Results: The results indicate that pedestrian fatalities involving vehicles traveling at low speeds occurred more often under daytime conditions across all vehicle types. At signalized intersections, the relative proportions of pedestrian fatalities were significantly higher when vehicles were traveling at low speed, except when the accidents involved box vans or SUVs. Similarly, when vehicles turned right, the relative proportions of pedestrian fatalities were significantly higher when vehicles traveling at low speed were involved across all vehicle types. In terms of the frontal right vehicle impact location, the relative proportions of pedestrian fatalities were significantly higher when trucks with GVW ≥7.5 tons or <7.5 tons, sedans, or LCVs traveling at low speed were involved.Conclusions: The situational characteristics of fatal pedestrian accidents involving vehicles traveling at low speeds identified in this study can guide targeted development of new traffic safety regulations or technologies specific to vehicle–pedestrian interactions at low vehicle travel speeds (i.e., driver alert devices or automated emergency braking systems). Ultimately, these developments can improve pedestrian safety by reducing the frequency or severity of vehicle–pedestrian accidents for vehicles turning right at intersections and/or reducing the number of resultant pedestrian fatalities.