Pedestrian Injuries Research Articles

Factors affecting pedestrian injury severity in pedestrian-vehicle crashes: Insights from a data mining and mixed logit model approach

There has been a concerning rise in pedestrian fatalities resulting from traffic accidents. This study conducts an in-depth analysis of the factors that contribute to the injury severity of pedestrians considering human, vehicle, roadway, and environmental characteristics of the crashes. A novel approach is proposed by combing a data mining technique and mixed logit models. First, the Apriori algorithm is employed to uncover patterns between fatal and incapacitating injury outcomes and their influencing factors. Then, mixed logit models are developed to investigate heterogeneity across all observations under two different lighting conditions. It is found that eight variables show heterogeneity affecting the injury severity of crash outcomes. Results also indicate that drivers older than 65 years old will increase the probability of pedestrian injury severity at dark-unlighted roads. Additionally, the present of signal and double yellow line has could increase the injury severity. Creating optimal lighting conditions at pedestrian crossings during nighttime hours and enhancing safety education initiatives for pedestrians are critical factors to improve pedestrian safety. The finding of this study will benefit policymakers and road safety professionals develop more effective strategies for preventing pedestrian injuries in vehicle crashes.

Prediction of pedestrian injuries in motorcycle-pedestrian crashes using THUMS FE-HBM

This study focuses on the high fatality rates associated with motorcycles as a mode of transport in India, surpassing trucks and cars. Over the last decade, motorcycle-related fatalities have seen a staggering increase of 232%. The Finite Element-Human Body Models (FE-HBM) have been validated for occupants and pedestrians in car crashes. However, the performance against motorcycle impact is lacking in the literature. The primary objective of this research is to evaluate the THUMS model for injury prediction in motorcycle-pedestrian impact scenarios using a finite element motorcycle model of a widely used two wheeler in India. The motorcycle model is initially validated against a rigid wall, after which it is utilised to predict injuries in real-life motorcycle-pedestrian crash scenarios. Through multi-body simulations, crucial pre-crash parameters such as pedestrian orientation, offset and speed are estimated for five actual motorcycle-pedestrian crashes. Subsequently, finite element simulations are conducted to validate the model’s accuracy in predicting pedestrian injuries. The study closely predicts the occurrence and location of fractures in long bones using strain-based criteria in four out of five cases.

Temporal trends in the incidence and mortality of road injuries in China: Current trends and future predictions

BackgroundChina has the highest number of road injury deaths in the world. The aim of this study was to determine the long-term incidence and mortality trends of road injuries in China between 1990 and 2019 and to make projections up to 2030. MethodsIncident and death data were extracted from the Global Burden of Disease (GBD) 2019 study and population data were extracted from the GBD 2019 and World Population Prospects 2019 studies. An age-period-cohort framework was used for the analysis. ResultsIn 2019, 16.1 million road injuries (age-standardized incidence rate [ASIR]: 991.3/100,000) occurred in China. Between 1990 and 2019, the ASIR of road injuries in China increased by 87.4 %. In 2019, there are 250.0 thousand road deaths (age-standardized mortality rate [ASMR]: 14.79/100,000), and the ASMR decreased by 27.0 % between 1990 and 2019. Period and cohort risks for the incidence of road injuries were increased for both sexes. Period and cohort risks for road injury mortality appeared to increase in recent period and birth cohorts. The ASIR of road injuries was projected to increase in the future, and the ASMR was projected to decrease; however, the ASIR of cyclist road injuries in females was projected to increase in the future. Among road injuries, elderly individuals were projected to have an increasing proportion of occurrence and death. Although the proportion is decreasing, pedestrian road injuries were projected to still account for more than half of road injury deaths in China up to 2030. ConclusionsThe incidence of road injuries in China has increased overall, while the overall mortality rate has decreased over the past 30 years, and this trend is expected to continue in the future. Effective effort is needed to improve road safety, especially for elderly individuals and female cyclists. In addition, pedestrian road safety also needs to be improved.

Rollator related pedestrian single accidents and collision events in Sweden

Rollators (four-wheel walkers in USA; zimmer frames in UK) are commonly used as mobility aids for the elderly and people with a variety of disabilities. Pedestrian rollator users are a sub-group of Vulnerable Road Users (VRUs), although this group is rarely recognised in traffic safety contexts. The aim of this study is to extract and analyse rollator related pedestrian accident and injury data in Sweden. The results will provide valuable insight into the risks and obstacles rollator users are exposed to in the traffic environment and may in the long term contribute to improving the mobility of this group. The current study is based on data from 2,020 accidents involving 2,305 persons extracted from the Swedish Traffic Accident Data Acquisition (STRADA) database. For consistency reasons, a subset of data (N = 745) was analysed in order to investigate the development of accidents over a period of 10 years. Thereafter, each accident in the whole data set was registered as either single or collision. The results show that the number of rollator accidents in Sweden increased by approximately 80% during 2007–2016. Females dominate the injury statistics of single accidents, collisions, as well as fatal outcome, which may be due to exposure and/or differences in physical characteristics. Single accidents are much more common than collisions (n=1,668 and n=352, respectively) and the injury consequences are at least as serious. Data from the present study have revealed that the frequency of minor injuries (ISS 1–3) is 4.3 times, moderate (ISS 4–8) 6.0 times and serious injuries (ISS 9–15) 8.9 times higher in single accidents than in collisions. Fatal injuries are, however, more common in collision events (33 in comparison to 8). The vast majority of single accidents (99%) was due to falls. Many of the single accidents (29%) were caused by ground level differences (typically a curb) or due to surface conditions (19%). Collisions involved cars, trucks or buses in 91% of cases, occurring predominantly in car parks (31%) and on (zebra) crossings (30%). In 54% of cases the vehicles reversed into the rollator. Abbreviated Injury Scale (AIS) 3+ injuries were dominated by head (36%) and torso (33%) injuries in collision events, and hip fractures (71%) in single accidents. The present study shows that further research into rollator user related accidents, both single accidents and collision events, is required. In order to introduce appropriate measures, future work should follow up on accident and injury developments and further improve the quality of mobility aid related accident data in general. Improved stability and design, proper training programmes, effective maintenance services, development of a supporting infrastructure would contribute to increased safety for rollator users.

Stability of factors influencing walking-along-the-road pedestrian injury severity outcomes under different lighting conditions: A random parameters logit approach with heterogeneity in means and out-of-sample predictions

Pedestrians walking along the road’s edge are more exposed and vulnerable than those on designated crosswalks. Often, they remain oblivious to the imminent perils of potential collisions with vehicles, making crashes involving these pedestrians relatively unique compared to others. While previous research has recognized that the surrounding lighting conditions influence traffic crashes, the effect of different lighting conditions on walking-along-the-road pedestrian injury severity outcomes remains unexplored. This study examines the variations in the impact of risk factors on walking-along-the-road pedestrian-involved crash injury severity across various lighting conditions. Preliminary stability tests on the walking-along-the-road pedestrian-involved crash data obtained from Ghana revealed that the effect of most risk factors on injury severity outcomes is likely to differ under each lighting condition, warranting the estimation of separate models for each lighting condition. Thus, the data were grouped based on the lighting conditions, and different models were estimated employing the random parameter logit model with heterogeneity in the means approach to capture different levels of unobserved heterogeneity in the crash data. From the results, heavy vehicles, shoulder presence, and aged drivers were found to cause fatal pedestrian walking-along-the-road severity outcomes during daylight conditions, indicators for male pedestrians and speeding were identified to have stronger associations with fatalities on roads with no light at night, and crashes occurring on Tuesdays and Wednesdays were likely to be severe on lit roads at night. From the marginal effect estimates, although some explanatory variables showed consistent effects across various lighting conditions in pedestrian walking-along-the-road crashes, such as pedestrians aged < 25 years and between 25 and 44 years exhibited significant variations in their impact across different lighting conditions, supporting the finding that the effect of risk factors are unstable. Further, the out-of-sample simulations underscored the shifts in factor effects between different lighting conditions, highlighting that enhancing visibility could play a pivotal role in significantly reducing fatalities associated with pedestrians walking along the road. Targeted engineering, education, and enforcement countermeasures are proposed from the interesting insights drawn to improve pedestrian safety locally and internationally.

STRIDE: Street View-based Environmental Feature Detection and Pedestrian Collision Prediction.

This paper introduces a novel benchmark to study the impact and relationship of built environment elements on pedestrian collision prediction, intending to enhance environmental awareness in autonomous driving systems to prevent pedestrian injuries actively. We introduce a built environment detection task in large-scale panoramic images and a detection-based pedestrian collision frequency prediction task. We propose a baseline method that incorporates a collision prediction module into a state-of-the-art detection model to tackle both tasks simultaneously. Our experiments demonstrate a significant correlation between object detection of built environment elements and pedestrian collision frequency prediction. Our results are a stepping stone towards understanding the interdependencies between built environment conditions and pedestrian safety.

Systems-Level Evaluation of Safe Routes to School Policies in El Paso, Texas: A Modeling Study on Health and Economic Outcomes.

Safe Routes to School (SRTS) policies are linked to physical health benefits for school-age children; however, few studies have assessed long-term impacts on cardiovascular disease (CVD). This study used systems science methods to predict long-term health and economic impact of SRTS among school-age children in El Paso County, Texas. We developed an agent-based model containing 2 modules: the pedestrian injury module and the CVD module. We simulated 10 000 school-age children under 2 scenarios-SRTS policies implemented and no SRTS policies implemented-and then calculated pedestrian injuries, pedestrian injury-related deaths, coronary heart disease (CHD) and stroke events, and health care costs. When SRTS policies were implemented, the model estimated 157 fewer CHD cases and 217 fewer stroke cases per 10 000 people and reduced CVD-related health care costs ($13 788 per person). The model also predicted 129 fewer pedestrian injuries and 1.3 injury-related deaths per 10 000 people and $2417 savings in injury-related health care costs. SRTS could save an estimated $16 205 per person in health care costs. This simulation shows SRTS in El Paso County could prevent pedestrian injuries among school-age children and protect cardiovascular health in the long term. Our findings provide evidence for practitioners and policy makers to advocate for SRTS policies at the local level.

Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

ObjectivesTo evaluate the most up-to-date burden of traumatic brain injury (TBI) and spinal cord injury (SCI) and analyse their leading causes in different countries/territories.DesignAn analysis of Global Burden of Disease...

Factors Influencing the Pedestrian Injury Severity of Micromobility Crashes

Factors Influencing the Pedestrian Injury Severity of Micromobility Crashes

Theorising Lebano-Pathography: A Biographical Exploration of Medical-Cultural Pathologies

ABSTRACT To introduce the special issue on illness writing in Lebanon, I theorise Lebano-pathography as a dual, potentially adaptable and reusable, (i) narrative intervention (form/method) that does not depoliticise the traumatic subject. Simultaneously, it is (ii) a body of writing (text) that seeks to illuminate the different ways one can be ill, and try to recover, in present-day Lebanon. While somatic manifestations of illness and their concomitant patient accounts are central to previous research in narrative medicine and illness writing, Lebano-pathography underscores a more versatile interpretation of illness encompassing cultural practice and/or clinical disease, and exploring in critically informed autobiographical text the two illness categories’ causal interrelationship. In the backdrop of the cadaverous political grid and economic tensions rending the country since the national tragedy of the August 4, 2020 explosion of Beirut Port, this volume unpacks the following thematic clusters: (1) Rewriting Illness: Pathographies of Gender and Sex; (2) The Alzheimer Spectrum: Cognitive and/or Cultural Memory Failure; (3) Walking the City: Medical Malpractice, Pedestrian Injuries, and Claustophobia; (4) The Bones Within: Immigrant Narratives and Vicarious Trauma; and (5) Surviving Trauma: Coping and Mental Health.

Reconstruction of a Car-Running Pedestrian Accident Based on a Humanoid Robot Method.

Due to the characteristics of multibody (MB) and finite element (FE) digital human body models (HBMs), the reconstruction of running pedestrians (RPs) remains a major challenge in traffic accidents (TAs) and new innovative methods are needed. This study presents a novel approach for reconstructing moving pedestrian TAs based on a humanoid robot method to improve the accuracy of analyzing dynamic vehicle-pedestrian collision accidents. Firstly, we applied the theory of humanoid robots to the corresponding joints and centroids of the TNO HBM and implemented the pedestrian running process. Secondly, we used rigid-flexible coupling HBMs to build pedestrians, which can not only simulate running but also analyze human injuries. Then, we validated the feasibility of the RP reconstruction method by comparing the simulated dynamics with the pedestrian in the accident. Next, we extracted the velocity and posture of the pedestrian at the moment of collision and further validated the modeling method through a comparison of human injuries and forensic autopsy results. Finally, by comparing two other cases, we can conclude that there are relative errors in both the pedestrian injury results and the rest position. This comparative analysis is helpful for understanding the differences in injury characteristics between the running pedestrian and the other two cases in TAs.

A Systematic Review and Meta-Analysis on the Efficacy of Virtual Reality Pedestrian Interventions to Teach Children How to Cross Streets Safely.

Over 7,000 American children die from pedestrian injuries annually, and pedestrian injury ranks among the top 5 causes of unintentional child death. Prevention efforts are multifaceted. One strategy, use of virtual reality (VR) to teach children to cross streets, is of growing interest to public health practitioners. The present study is a systematic review and meta-analysis that examined the efficacy of using VR to teach children pedestrian safety. Following PRISMA guidelines, searches among 7 databases were completed, followed by abstract/full-text screening and data extraction. Hedge's g was computed for the effect sizes of 3 outcomes: pedestrian knowledge, pedestrian-relevant cognition (attention to traffic, time to contact, start delay), and pedestrian behaviors (safe crossings, unsafe crossings). Risk of bias was assessed using Cochrane guidelines. Meta-regression analyses and subgroup analyses were conducted including 3 moderators: age, sex, and immersion level. A total of 20 studies, reported in 24 articles, were included in the qualitative analysis. Meta-analysis of the 12 studies with sufficient quantitative data available showed a statistically significant medium effect of VR safety interventions on child pedestrian knowledge and behavior. Mixed results emerged for the effect of VR safety interventions on children's pedestrian-relevant cognition. Age and sex moderated the effect of VR training on pedestrian knowledge. This synthesis of the literature on pediatric VR pedestrian safety interventions suggests an overall beneficial impact of VR interventions to teach children how to cross streets safely. Efforts should continue to develop and disseminate effective VR interventions. CRD42022309352.

Comparative evaluation for alternative variable importance rankings for pedestrian injury severities

Little research is dedicated to evaluating the performance difference of various metrics in ranking predictor importance in the traffic safety field. To this end, the main objective of the current paper is to evaluate and quantify different methods for sorting the variable importance related to crash severity. A comprehensive database for pedestrian-related crashes in the state of California was developed. Four popular measurement metrics used in the past were chosen for evaluation purpose: Mean Decrease Accuracy (MDA), Mean Decrease Gini (MDG), log-likelihood ratio test associated with multinomial logit model, and Principal Component Analysis (PCA). The former two metrics come under the same umbrella of the Random Forest (RF) technique, while the latter two are methods belonging to different domains. The results show the alternative methods yield different variable importance rankings with PCA being isolated from others. The two methods under the same domain of the random forest, or MDG and MDA, have the most common results, but still reveal a 17% ranking difference. It is anticipated that the results could raise more awareness of the importance of selecting the appropriate metrics to evaluate the predictor importance from different perspectives.

Fat Embolism Syndrome after Femoral Fracture Fixation due to Pedestrian Injury

Fat embolism syndrome (FES) is a rare but serious complication that primarily occurs in patients with long bone fractures. Herein, we report a case of sudden death due to FES, which was later confirmed by autopsy. The clinical course and pathological findings of the case are also presented. A 79-year-old male pedestrian was struck by a car while crossing a crosswalk, and due to the impact, he flew 4.5 meters away. He was admitted to the emergency room and diagnosed with an intertrochanteric fracture of the right femur. Upon admission, he had clear consciousness and normal vital signs. The patient died 27 hours after trauma during surgery for a right femur fracture. Histological examination revealed fat droplets in lung tissue. The diagnosis of FES was confirmed based on clinical and histological findings.

68 The Diurnal and Seasonal Relationships of Young Pedestrian Injuries Secondary to Motor Vehicles

Abstract Aim There remains a significant morbidity and mortality in young pedestrians hit by motor vehicles. The of this study was to compare the incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population. Method Data was retrieved from the National Trauma Audit and Research Network (TARN) database for patients between 10-25 years old who had been involved as pedestrians in motor vehicle accidents between 2013 -2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), and mortality were analysed according to the hours of daylight, darkness, and season. Results The study identified a seasonal pattern, highlighting that injuries were most prevalent during autumn (34.9% of injuries). Prevalence decreased throughout the year from winter (25.4%) to summer (18.3%). The greatest incident rate (number of incidents/hour) occurred between 1500-1630hrs, correlating to school pick up times. A significant relationship between ISS and daylight hours was demonstrated (p-value = 0.0124), whereby moderate injuries (ISS score: 9-15) were more likely during the day (72.7%), while severe injuries (ISS Score &amp;gt; 15) were more likely at night (55.8%). Conclusions We identified a relationship between the time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest incidents rate, suggesting that reduced visibility coupled with school pick up times play a significant role. We recommend targeted public health measures to improve road safety that focus on these high-risk times of the day.

Exploring nighttime pedestrian crash patterns at intersection and segments: Findings from the machine learning algorithm

Introduction: Pedestrian safety at nighttime is an ongoing critical traffic safety concern. Although poor visibility is primarily associated with nighttime pedestrian crashes, other contributing factors such as humans, vehicles, roadways, and environmental factors interact with each other to cause a crash. Additionally, the pattern of nighttime pedestrian crashes differs significantly according to the intersection and segment location, which requires further exploration. Data: This study applied Association Rules Mining (ARM), a rule-based machine learning method, to reveal the association of nighttime pedestrian crash risk factors according to the intersection and segment locations using 2,505 nighttime pedestrian fatal and injury crashes in Louisiana (2015–2019). Results and conclusions: Based on the generated rules, the results show that nighttime pedestrian crashes at the intersection are associated with right-turn vehicle movement, older drivers (>64 years) at the high-speed intersection, senior pedestrians (>64 years) in rainy weather conditions, violation by pedestrian age group ‘<15 years’, and alcohol-intoxicated pedestrian violation in business/industrial areas. Additionally, ‘careless operation’ at the intersection is associated with alcohol-involved drivers. Most of the nighttime pedestrian crashes at segments are associated with roadways with no physical separation and the absence of streetlights. Driver alcohol involvement and their physical condition (inattentive/distracted) are also associated with pedestrian crashes associated at the segment location at night. Other segment pedestrian crashes are linked to the interstate in dark conditions, open country locations, and high-speed roadways. Additionally, the crash site investigation identified several critical pedestrian safety concerns including the lack of crosswalk facilities, high driveway density, and pedestrian behavioral patterns (e.g., crossing at roadway segments close to the intersection location). Practical Applications: The findings of this study can be used for selecting the appropriate countermeasures based on a case-by-case basis. The exposure patterns can be used in educational campaigns to strategically reduce nighttime pedestrian crashes.

Evaluation of risk injury in pedestrians’ head and chest region during collision with an autonomous bus

Autonomous vehicle (AV) can detect pedestrians with high accuracy by utilising various sensors. Although it is an undesirable condition, traffic crashes can occur if any sensor misfunctions. This paper focuses to measure the severity of pedestrian injury during autonomous bus-pedestrian crashes via finite element simulation as pedestrians are very vulnerable in traffic crashes. Two types of vehicle impact were considered (frontal and side), and risk injury in head and chest region were evaluated. Effect of vehicle velocity (ranging from 5–10 m/s) on risk probability were evaluated. It was found that higher velocity caused more damage to pedestrian body, and frontal impact was more severe than the side impact. Maximum values of head-injury-criteria and chest acceleration were 248 and 36 g, respectively, when vehicle speed was 10 m/s. AV developers can use these results to implement a safer AV design and reduce pedestrian risk injury.

Pediatric emergency department visits for pedestrian injuries in relation to the enactment of Complete Streets policy.

This study aimed to evaluate the rate of pediatric emergency department (ED) visits for pedestrian injuries in relation to the enactment of the Complete Streets policy. The National Complete Streets policies were codified by county and associated with each hospital's catchment area and date of enactment. Pedestrian injury-related ED visits were identified across 40 children's hospitals within the Pediatric Health Information System (PHIS) from 2004 to 2014. We calculated the proportion of the PHIS hospitals' catchment areas covered by any county policy. We used a generalized linear model to assess the impact of the proportion of the policy coverage on the rate of pedestrian injury-related ED visits. The proportion of the population covered by Complete Streets policies increased by 23.9%, and pedestrian injury rates at PHIS hospitals decreased by 29.8% during the study period. After controlling for years, pediatric ED visits for pedestrian injuries did not change with increases in the PHIS catchment population with enacted Complete Streets policies. After accounting for time trends, Complete Streets policy enactment was not related to observed changes in ED visits for pedestrian injuries at PHIS hospitals.

Study of Pedestrian Injuries and Fatalities in Road accidentsat Tertiary Care Hospital in Maharashtra

Background: The Majority of the roads are narrow in India and unrepaired with multiple pits. Heavy traffic, rashand negligent driving lead to injuries to pedestrians and also cause fatal accidents.Method:450 pedestrians were brought to the Government Medical College and Hospital, Aurangabad, andstudied. Out of 450 cases, 63 (14%) had fatal fractures that were studied with an x-ray, CT scan, or MRI. Seriouspedestrians were admitted to the ICU; the remaining was treated by Orthopaedics and neurosurgeons.Results:128 (23.4%) were alcoholics, 54 (12%) had a visual problem, and 15 (3.2%) had Auditory problem: 38(8.44%)were mentally challenged (also included cases with psychiatric illness), 51(11.3%) were on antidepressanttreatment, 104 (23.1%) were busy in mobile speaking, and 60 (13.3%) were playing on the roadside. Maximumfractures observed were 107 (22.8%); cranial haemorrhage was followed by 98 (21.7%) fracture of the skull. Therewere 02 (0.44%) injuries to the kidney superficially or subcutaneously as four wheelers and two wheelers hit thepedestrians at the lumbar region, 3 (0.66%) in the aorta. The fatalities were 63 (14%). Among them, 40 (63.4%) hadhaemorrhage and shock; 16 (25.3%) had head injuries; 5 (7.93%) had septicaemia; and 2 (3.10%) had uraemia.Conclusion: Well-built roads, fencing or barriers for pedestrians, awareness of traffic rules, and stringentpunishment for both pedestrians and drivers of vehicles violating traffic rules can minimize pedestrian roadaccidents and fatalities.

Road safety hazards for children while commuting to school: Findings from a pilot study in Karachi, Pakistan

IntroductionRoad traffic injuries are a leading cause of mortality and morbidity among children. Travelling to and from school is a major risk exposure for children around the globe. ObjectiveThe purpose of this study was to assess road traffic injury hazards for school children during dropp-off or picked-up times. MethodsThis observational cross-sectional study included 94 public and private schools in Karachi, Pakistan. A structured observational tool was used to collect data on school demographics, the road traffic environment, infrastructure, injury hazards in vehicles used by school children, and child pedestrian injury risk and road use behaviors. ResultsA total of 860 observations of school children, drivers of vehicles transporting children, schools, and vehicles were recorded. Most schools (n = 83, 88%) did not have designated parking spaces around the school; only one public school had a parking area. Only one private school had a zebra crossing around the school premises. Very few schools (n = 13, 14%), mostly private (n = 12) had pedestrian sidewalks. Only 35 (18%) adult motorcyclists, out of 199, were wearing a helmet, and eight (6%), out of 145, car passengers were wearing seatbelts. Compressed natural gas (CNG) cylinders were installed in 83 (35%), out of 235, observed vehicles. The remaining 152 (65%) did not have CNG cylinders or they were not visible to our data collectors. In 55 (23%) observations, bus passengers stepped off the bus in the middle of the road. Most pedestrians (n = 266, 99.5%) did not use a Zebra crossing. More than a quarter (n = 74, 28%) of pedestrians looked left and right before crossing the road. ConclusionWhile traveling to school, either by walking or taking vehicular trips, children face many road traffic injury hazards in Karachi. Pedestrians and passengers exhibited risky behaviors while using roads. Further initiatives are advised from a public health viewpoint aiming at minimizing transport-related hazards.