Risk Of Fatal Injury Research Articles

Factors affecting motorcycle crash casualty severity at signalized and non-signalized intersections in Ghana: Insights from a data mining and binary logit regression approach

Despite the countless benefits derived from motorcycle usage, it has become a significant public health concern, particularly in developing countries, due to the plateauing number of fatal/serious injuries associated with them. Although it has been well documented that the frequency and fatality rates of intersection-related motorcycle crashes are high, little research efforts have been made to explore the contributory factors influencing motorcycle-involved crashes at these locations. Interestingly, no study has investigated the latent patterns and chains of factors that simultaneously contribute to the injury severity sustained by motorcycle crash casualties at intersections under different traffic control conditions in developing countries. Since motorcycles are mostly used as taxis in developing countries, it is imperative to consider the injury severity sustained by all crash casualties in the motorcycle safety analysis. This study bridges the research gap by employing a plausible data mining tool to explore hidden rules associated with motorcycle crash casualty injury severity outcomes at both signalized and non-signalized intersections in Ghana's most densely populated region, Accra, using three-year crash data spanning 2016–2018. Besides, a binary logit regression model was also employed to explore the impact of crash factors on casualty severity outcomes using the same dataset. The results from both analysis techniques were consistent; however, the data mining technique provided chains of factors which provided additional insights into the groups of factors that collectively influence the casualty injury severity outcomes. From the rule discovery results, while full license status, daytime/daylight, and shoulder presence increased the risk of fatal injuries at signalized intersections, factors such as inattentiveness, good road surface, nighttime, shoulder absence, and young rider were highly likely to increase casualty fatalities at non-signalized intersections. By controlling all or some of these risk factors, the level of injury severity on the roadways could be reduced. Based on the findings, we provide enforcement, education, and engineering-based recommendations to help improve motorcycle safety.

Visual Acuity and the Risk of Cycling Injuries: Register-Based Cohort Study From Adolescence to Middle-age.

Cycling is increasingly encouraged in many countries as an inexpensive and healthy choice of transportation. Operating any vehicle on the road requires high visual acuity, but few studies to our knowledge have examined the association between vision and cycling injuries. We examined whether poorer visual acuity is associated with increased risk of fatal and nonfatal cycling injuries. We used prospectively recorded register data for 691,402 men born between 1970 and 1992 in Sweden. We followed these men from an average age of 18 years, when visual acuity was assessed during the conscription assessment, to age 45 at the latest. We identified fatal and nonfatal cycling and car injuries using Patient and Cause of Death registers. Cox regression models were used to estimate hazard ratios and 95% confidence intervals. Based on visual acuity for the eye with the best vision, moderately impaired acuity 0.9 to 0.6 when wearing refractive correction was associated with increased risk for cycling injuries (hazard ratio = 1.44 [95% confidence interval = 1.16, 1.79]) compared with unimpaired vision (uncorrected visual acuity 1.0) and after adjustment for a wide range of potential confounders. This association remained consistent across various sensitivity analyses. Visual acuity was not associated with car injury risk. In this cohort study, poorer vision was specifically associated with a higher rate of cycling injuries.

Socioeconomic inequalities in cycling safety: An analysis of cycling injury risk by residential deprivation level in England

IntroductionPrevious studies have found a positive association between cycling injury risk and residential deprivation. However, most of these studies focused on serious and fatal injuries, children, and a specific point in time. This study explores i) inequalities in cycling injury risk by residential deprivation for all recorded casualties (slight, serious, and fatal) in England, ii) whether these inequalities vary by sex and age, and iii) how they have changed over time. MethodsUsing the STATS19 database of road traffic casualties in Britain, the English National Travel Survey, and population estimates for England over the six-year period 2014–2019, we estimated the ratio of slight, serious, and fatal cycling casualties per billion kilometres cycled by residential Index of Multiple Deprivation (IMD) quintile; by residential IMD quintile and sex and age group; and by residential IMD quintile and year. ResultsWe found that the higher the level of residential deprivation, the higher the slight and serious cycling injury risk. The fatal cycling injury risk was also higher in individuals from the most deprived areas. Inequalities were particularly large for children, with slight and serious rates three times higher for children from the most deprived areas than for children from the least deprived areas. We also found that the linear trend lines of the slight and serious injury rates between 2014 and 2019 declined in the least deprived quintiles but not in the most deprived quintiles, which suggests that inequalities in slight and serious cycling injuries may have grown over the last years. ConclusionThis study found that people from deprived areas are at higher risk of cycling injury for all types of severity; that children from deprived areas are most at risk; and that these inequalities may have recently increased.

Exploring the relationship of rush hour period and fatal and non-fatal crash injuries in the U.S.: A systematic review and meta-analysis

Road crashes are preventable causes of morbidity and mortality. In the U.S., substantial crashes occur during the rush hour period. The rush hour represents the period of the day during which the density of humans and vehicles in the road environment is highest. In the U.S., the rush hour period is bi-modal, occurring in the morning and the afternoon, at times that vary by state and urban–rural status. This systematic review and meta-analysis aimed to evaluate the association between the rush hour period and fatal and non-fatal crash injuries. Selected articles were limited to peer-reviewed full-text articles that measured crash injury as an outcome and rush hour as either a predictor, covariate, stratification, or a control variable. A total of 17 articles were identified for systematic review and nine articles were included in the meta-analysis. Across the selected studies, the rush-hour period signified the period of “peak traffic flow.” During the rush hour period, aggressive driving behavior, truck driving, bicycle riding, and precipitation were associated with increased crash events or crash injuries. Across the nine studies included in the meta-analysis, the effective sample size was 236,433. The rush-hour period was associated with a 28% increased risk of fatal crash injury (Pooled RR: 1.28; 95% CI: 1.11–1.45) and the morning rush hour period was associated with 36% increased crash injury risk (Pooled RR: 1.36; 95% CI: 1.13–1.59). The rush hour period, though less commonly studied as a predictor of fatal and non-fatal crash injuries, represents an important domain in need of crash injury prevention attention. The knowledge of the pattern of crash injuries, as it varies across countries, states, regions, and county can inform policy and intervention, in the presence of competing public health needs.

Fatal Injury Risk Model (FIRM) of the Road Accidents that Occurred in Rainy Conditions — A Probabilistic Approach

Fatal Injury Risk Model (FIRM) of the Road Accidents that Occurred in Rainy Conditions — A Probabilistic Approach

Traffic Injury Risk Based on Mobility Patterns by Gender, Age, Mode of Transport and Type of Road

The role of gender and age in the risk of Road Traffic Injury (RTI) has not been fully explored and there are still significant gaps with regard to how environmental factors, such as road type, affect this relationship, including mobility as a measure of exposure. The aim of this research is to investigate the influence of the environmental factor road type taking into account different mobility patterns. For this purpose, a cross-sectional study was carried out combining two large databases on mobility and traffic accidents in Andalusia (Spain). The risk of RTI and their severity were estimated by gender and age, transport mode and road type, including travel time as a measure of exposure. Significant differences were found according to road type. The analysis of the rate ratio (Ratemen/Ratewomen), regardless of age, shows that men always have a higher risk of serious and fatal injuries in all modes of transport and road types. Analysis of victim rates by gender and age groups allows us to identify the most vulnerable groups. The results highlight the need to include not only gender and age but also road type as a significant environmental factor in RTI risk analysis for the development of effective mobility and road safety strategies.

Side-Impact Collisions involving Passenger Vehicles in Real-World Crashes


 
 
 In Malaysia, 6,570 fatalities were recorded as a result of road deaths in 2016. From that figure, 1,197 or 18.2% were involved in side- impact collisions. An in-depth crash investigation study was conducted by utilizing data from the MIROS crash investigation database (MICARS) to better understand the mechanism and characteristics of the crash and to correlate the impact and damages profile with the injury outcome of the involved occupants related to the side-impact crash. The data obtained from MICARS for this study was selected from 2007 until 2016, during which MIROS had investigated 794 for both East and West Malaysia. Out of that number, 41 cases involving passenger vehicles were selected for analysis purposes. The results found that the risk of serious or fatal injury to nearside occupants was eight times higher compared to the far-side occupants. Besides that, the use of the restraint system does not show a significant association with the occupants' fatality. In a conclusion, car manufacturers should equip all new passenger vehicle models with passive safety features such as side and curtain airbags and should also increase the rigidity of the side structure of the said vehicles to reduce the injury severity level of the occupants. Furthermore, the government needs to review all these issues together with the vehicle manufacturers to make it become a Malaysian Standard before mandating it for all passenger vehicles in Malaysia. Thus, continuous efforts and commitment by car manufacturers and the government are essential to produce safer cars with proper and adequate active and passive safety features.
 
 

Geographical risk of fatal and non-fatal injuries among adults in Norway

Introduction: A rural gradient in trauma mortality disfavoring remote inhabitants is well known. Previous studies have shown higher risk of traumatic deaths in rural areas in Norway, combined with a paradoxically decreased prevalence of non-fatal injuries. We investigated the risk of fatal and severe non-fatal injuries among all adults in Norway during 2002–2016.Methods: All traumatic injuries and deaths among persons with a residential address in Norway from 2002–2016 were included. Data were collected from the Norwegian National Cause of Death Registry and the Norwegian Patient Registry. All cases were stratified into six groups of centrality based on Statistics Norway's classification system, from most urban (group one) to least urban/most rural (group six). Mortality and injury rates were calculated per 100,000 inhabitants per year.Results: The mortality rate differed significantly among the centrality groups (p<0.05). The rate was 64.2 per 100,000 inhabitants/year in the most urban group and 78.6 per 100,000 inhabitants/year in the most rural group. The lowest mortality rate was found in centrality group 2 (57.9 per 100,000 inhabitants/year). For centrality group 6 versus group 2, the risk of death was increased (relative risk, 1.36; 95%CI: 1.11–1.66; p<0.01). The most common causes of death were transport injury, self-harm, falls, and other external causes. The steepest urban–rural gradient was seen for transport injuries, with a relative risk of 3.32 (95%CI: 1.81-6.10; p<0.001) for group 6 compared with group 1. There was a significantly increasing risk for severe non-fatal injuries from urban to rural areas. Group 2 had the lowest risk for non-fatal injuries (1531 per 100,000 inhabitants/year) and group 6 the highest (1803 per 100,000 inhabitants/year). The risk for non-fatal injuries increased with increasing rurality, with a relative risk of 1.07 (95%CI: 1.02–1.11; p<0.01) for group 6 versus group 1.Conclusions: Fatal and non-fatal injury risks increased in parallel with increasing rurality. The lowest risk was in the second most urban region, followed by the most urban (capital) region, yielding a J-shaped risk curve. Transport injuries had the steepest urban–rural gradient.

Investigation of factors influencing motorcyclist injury severity using random parameters logit model with heterogeneity in means and variances

Motorcyclists are an integral component of the traffic stream especially, in low-income developing countries like Pakistan. However, motorcyclists lay in the group of vulnerable road users i.e., road users with the least protection, along with pedestrians and cyclists. Therefore, the current study employed the random parameters logit model to identify key risk factors associated with motorcyclist injury severity using three years crash data (2017-2019) for city of Rawalpindi, Pakistan. To calibrate the model, motorcyclist injury severity thresholds are classified as no injury, minor injury, severe injury, and fatal injury. For motorcyclist injury severity analysis, the effects of vehicle crash characteristics, weather conditions, rider attributes and other socio-demographic considerations were primarily considered. The study results showed that severe and fatal injury risk is increased for crashes occurred during weekdays, involving riders aged above 50 years, involving the collision of motorcycles with passenger car and heavy vehicles, involving a female as a pillion rider, and those that occurred due to over speeding. Based on the results obtained from the model, the study suggests several policy implication as strict implementation of traffic regulations such as heavy fines or cancellation of driving license on over speeding, wrong turns, inappropriate passing, running a red light, not wearing helmet etc., instructing the females not to wear loose clothes or trailing scarves while riding the bike as pillion riders. The outcomes are expected to stimulate more interest and discussion regarding motorcycle safety in the country and can be used by city traffic police and highway authorities to boost the road safety.

Risk of Physical Injury for Dispatched Citizen Responders to Out-of-Hospital Cardiac Arrest.

BackgroundCitizen responder programs are implemented worldwide to dispatch volunteer citizens to participate in out‐of‐hospital cardiac arrest resuscitation. However, the risk of injuries in relation to activation is largely unknown. We aimed to assess the risk of physical injury for dispatched citizen responders.Methods and ResultsSince September 2017, citizen responders have been activated through a smartphone application when located close to a suspected cardiac arrest in the Capital Region of Denmark. A survey was sent to all activated citizen responders, including a specific question about risk of acquiring an injury during activation. We included all surveys from September 1, 2017, to May 15, 2020. From May 15, 2019, to May 15, 2020, we followed up on all survey nonresponders by phone call, e‐mail, or text messages to examine if nonresponders were at higher risk of severe or fatal injuries. In 1665 suspected out‐of‐hospital cardiac arrests, 9574 citizen responders were dispatched and 76.6% (7334) answered the question regarding physical injury. No injury was reported by 99.3% (7281) of the responders. Being at risk of physical injury was reported by 0.3% (24), whereas 0.4% (26) reported an injury (25 minor injuries and 1 severe injury [ankle fracture]). When following up on nonresponders (2472), we reached 99.1% (2449). No one reported acquired injuries, and only 1 reported being at risk of injury.ConclusionsWe found low risk of physical injury reported by volunteer citizen responders dispatched to out‐of‐hospital cardiac arrest. Risk of injury should be considered and monitored as a safety measure in citizen responder programs.

Combat, casualties, and compensation: Evidence from Iraq and Afghanistan

AbstractOur research examines the effect of combat deployments to Iraq and Afghanistan on casualties and combat exposure compensation policy. We use restricted data from the Defense Manpower Data Center (DMDC) and Social Security Administration (SSA) to construct a panel of all US Active Duty service members having served at some point during the years 2001–2012. Casualties disproportionately occur at higher rates among (i) young, white, males, (ii) enlisted personnel, (iii) less educated personnel, and (iv) those in combat job types. Our estimates indicate that overall US military personnel who deployed in an individual year to Iraq or Afghanistan had a 45 per 100,000 higher probability of death than non‐deployed military personnel who remained stateside. The increased fatal injury risk of deployed US military personnel is 15 times higher than the national average civilian workplace fatality rate, but roughly equal to the fatal injury risk faced in some of the most dangerous civilian occupations. Our estimates suggest a compensating wage differential equal to $861 per month would be appropriate in comparison to the current average of $1238 per month in danger pay provided to US military personnel deployed into combat zones. We recommend a revenue‐neutral approach in adjusting the pay structure for military members. For example, the military should consider increasing bonuses or base pay while simultaneously decreasing danger pay by an equivalent amount. Furthermore, it may be beneficial to adjust danger pay by service or job type to reflect fatality risk more accurately.

Analysis of Pedestrian–Motor Vehicle Crashes in San Antonio, Texas

Pedestrian safety is becoming a global concern and an understanding of the contributing factors to severe pedestrian crashes is crucial. This study analyzed crash data for San Antonio, TX, over a six-year period to understand the effects of pedestrian–vehicle crash-related variables on pedestrian injury severity based on the party at fault and to identify high-risk locations. Bivariate analysis and logistic regression were used to identify the most significant predictors of severe pedestrian crashes. High-risk locations were identified through heat maps and hotspot analysis. A failure to yield the right of way and driver inattention were the primary contributing factors to pedestrian–vehicle crashes. Fatal and incapacitating injury risk increased substantially when the pedestrian was at fault. The strongest predictors of severe pedestrian injury include the lighting condition, the road class, the speed limit, traffic control, collision type, the age of the pedestrian, and the gender of the pedestrian. The downtown area had the highest crash density, but crash severity hotspots were identified outside of the downtown area. Resource allocation to high-risk locations, a reduction in the speed limit, an upgrade of the lighting facilities in high pedestrian activity areas, educational campaigns for targeted audiences, the implementation of more crosswalks, pedestrian refuge islands, raised medians, and the use of leading pedestrian interval and hybrid beacons are recommended.

The relationship between motor vehicle speed and active school transportation at elementary schools in Calgary and Toronto, Canada

BackgroundHigher traffic speeds increase the risk of serious or fatal injury to child pedestrians and may deter parents from encouraging their children to walk to school. This cross-sectional study examined the association between measured vehicle speed and active school transportation. MethodsThe study sample included public elementary schools in Calgary (n = 46) and Toronto (n = 42), Canada. Speed limits in school zones were 30 km/h in Calgary but ranged from 30 to 60 km/h in Toronto. In May and June 2018, trained observers counted children arriving to school and recorded their mode of travel. Vehicle speeds around schools were measured between 07:30 and 18:00 (school activity hours) and quantified as the 85th percentile speed, the percentage of vehicles exceeding 30 km/h, and the percentage of vehicles exceeding the speed limit. Multivariable beta regression was used to examine the relationship between vehicle speed and active transportation to school for each city, adjusting for school environment features. ResultsA high percentage of vehicles were travelling over the speed limit in front of schools: 45% in Calgary and 42% in Toronto. No association between vehicle speed and active school transportation was found in Calgary (mean 85th percentile speed OR: 0.99, 95% CI: 0.93, 1.06). There was an inverse association between vehicle speed and active school transportation in Toronto, where for every 1 km/h increase in the mean 85th percentile speed, the odds of active school transportation decreased by 3% (OR: 0.97, 95% CI: 0.95, 0.99). ConclusionThere was a high prevalence of speeding in front of schools, which could increase the risk of traffic-related injuries and fatalities to children. Speed limit reductions to 30 km/h on roads near schools may be a useful preventive intervention in Toronto during school activity hours. Such targeted interventions can help improve child pedestrian safety and promote active school transportation.

Numerical Assessment of Motorcyclist Accident

&#x0D; &#x0D; &#x0D; Road traffic accidents cause one of the highest numbers of severe injuries. Virtual human body models play an important role to assess the injuries during impact loading especially for scenarios, where complex dynamical loading is taken into account. It concerns mainly vulnerable road users, where motorcyclists are addressed. The risk of fatal injuries connected to motorcycle usage is still one of the biggest among all modes of transportation. Due to a complicated interaction between a motorcycle and an opposite vehicle during their crash, the virtual approach is an optimal way towards a crash reconstruction. The presented work shows the exploitation of virtual a human body model in the injury assessment during the motorcycle against car accident using the virtual approach by the numerical simulation. The study exploits an existing human body model as a helmeted motorcycle rider, couples it to a motorcycle model and runs a simulation, where the motorcycle impacts an opposite vehicle according to a real case. Injury assessment and comparison to the real case is analysed. The paper shows the advantages of the virtual approach in a complex impact scenario reconstruction in order to optimize the personal protective equipment for injury risk reduction in future transport.&#x0D; &#x0D; &#x0D;

Evaluation of a warning system to reduce the risk of casualty crashes at rural junctions in South Australia

Objective This study evaluated the effectiveness and potential safety benefits of a Rural Junction Active Warning System (RJAWS), which uses variable speed limit signs (VSLSs) to temporarily impose a reduced speed limit along the major road when another vehicle is approaching on the minor road or turning into the minor road from the far-side major leg. Methods The RJAWS was trialed at 4 3-leg rural junctions between 2-lane roads in South Australia. A quasi-experimental before–after analysis was conducted. The free-flow speed of vehicles along the junction major approaches was used as an indicator of the risk of a casualty crash with adjacent traffic. Events with activated and nonactivated VSLSs after the RJAWS installation were analyzed separately. Travel speed, speed limit compliance, and the relative risk of a casualty crash were compared. The potential risk of casualty crashes relative to traveling at the default speed limit was calculated based on a known relationship between travel speed and relative casualty risk for rural roads in South Australia. Results When the reduced speed limit signs are activated, the average travel speed along the major road is reduced between 11.3 and 22.1 km/h, with a consequent reduction of the expected average casualty risk between 42% and 65% compared to before the RJAWS installation. . Though compliance with the reduced posted speed limit was low, the RJAWS still proved effective in reducing travel speed because the majority of drivers traveled through the monitored junctions at speeds below the default speed limit when the sign was activated. Conclusions This evaluation indicated that the trialed RJAWS can potentially reduce the risk of fatal and serious injuries at junctions under conditions that may present the opportunity for an adjacent-direction collision with another vehicle. Extending the RJAWS installation to additional junctions is strongly suggested. Further monitoring is needed to determine whether safety benefits are sustained over the long term.

Analysing the injury severity characteristics of urban elderly drivers’ traffic accidents through the generalised ordered logit model: A case of Seoul, South Korea

As ageing population is growing faster, traffic accidents involving elderly drivers become a serious social problem in South Korea. The present study aims to examine the impact of environmental characteristics on the injury severity of accidents involving elderly drivers in Seoul, South Korea. To achieve the purpose, the study divided elderly drivers into the following two groups: young-elderly drivers aged 65–69 years and middle- and old-aged drivers over 69 years old. The study also analysed non-elderly drivers aged 30 to 64 years as the comparative group. The study used the generalised ordered logit model, which is widely used to analyse data with ordinal scales. The findings from the study draw attention to the fact that (1) the characteristics of traffic accidents by injury severity considerably differed by age group. (2) risk of accident severity involving elderly drivers increase in areas with heavy traffic volumes and facilities that may create a complex driving condition to elderly drivers, (3) since elderly drivers tend to require longer response time with impaired vision under complex driving environment, it increased the risk of traffic accidents that older drivers face a higher risk of fatal injuries than younger counterparts. Thus, in order to reduce traffic accidents involving elderly drivers, the traffic safety policies should take environmental characteristics as well as the human factor concerning elderly drivers’ difficulties because of ageing and longer cognitive response time. This study contributes to the research in traffic accidents involving elderly drivers in that not only the accident characteristics (human factors, road condition, weather), mostly used for traffic accident analysis, but also environmental factors concerning the urban characteristics of Seoul Metropolitan City were analysed to compare the risk of traffic accidents and accident severity by age groups.

A reappraisal of injuries and accidents in people with epilepsy.

We review data on injuries and traffic accidents affecting people with epilepsy with emphasis on the overall risk of injuries, specific types of injuries, and risk factors. Population-based studies of incident epilepsy cohorts indicate that the risk of physical injuries in people with epilepsy in general is increased only modestly. The risk is higher in selected populations that attend epilepsy clinics or referral centers. Soft tissue injuries, dislocations, and fractures are the most common injures, whereas the greatest increase in risk is reported for more uncommon injuries such as drowning. People with epilepsy are at a two-fold to four-fold increased risk for fatal injuries. Comorbidities contribute to fatal as well as nonfatal injuries. The other major risk factor is poorly controlled major convulsive seizures (generalized as well as focal to bilateral tonic-clonic seizures). Serious transport accidents associated with increased risks for people with epilepsy include pedestrian, bicycle, as well as car accidents. Individualized information on the risk of physical injuries and accidents should be part of counseling of patients with epilepsy. Improved seizure control is likely the most effective way to reduce risks, but work place and home adjustments should also be considered.

РАЗВИТИЕ РИСК-ОРИЕНТИРОВАННОГО ПОДХОДА ДЛЯ ВЫБОРА ПРИОРИТЕТНЫХ НАПРАВЛЕНИЙ СНИЖЕНИЯ ПРОИЗВОДСТВЕННОГО ТРАВМАТИЗМА В АО "СУЭК-КУЗБАСС"

Indicators of industrial injuries in the Russian coal industry remain unacceptably high. Solutions to this problem should be sought in the way of accident prevention, which can be achieved through operational risk management of injuries, implemented by analyzing the state of labor protection for this factor, followed by determining the causes that lead to injuries. On the example of SUEK-Kuzbass JSC, the risks of light, severe, fatal and general injuries were calculated. Based on the individual regression coefficients of the obtained correlations of injury risks, the mines were ranked according to the level of industrial injuries. For a more detailed assessment of the state of labor protection, a matrix of the causes of accidents and their severity is proposed, which displays a qualitative description of the situation at the enterprise.

Statistical risk management analysis for hazardous oil and gas production facilities

Modern production conditions show that labor protection and industrial safety are one of the most important tasks of the government and oil and gas companies. The article aims to analyze the dynamics of accidents and industrial injuries with fatal outcomes that occurred at oil and gas production facilities in 2008-2018. The methods of statistical research were used. These are retro-perspective analysis and Shewhart control charts. The data on fatal industrial injuries in the Russian oil and gas production industry provided by the Federal Service for Environmental, Technological and Nuclear Supervision were used. Having analyzed the maps and identified the points beyond the upper and lower boundaries of average values, the conclusions about the random / systemic nature of damage to the health of workers were drawn. The results allowed us to analyze the risk of fatal injuries, their causes and find ways to reduce them. The effective operation and modernization of the industrial safety management system, constant development and an annual increase in the level of safety at hazardous production facilities is one of the main tasks of managers.

Adult pedestrian and cyclist injuries in Lilongwe, Malawi: a cross-sectional study.

Pedestrian and cyclist injuries are a major concern globally, but especially in low-income countries. Locally conducted research is needed to measure the size of the problem and advise policy on road safety interventions. We wanted to investigate the precise circumstances of these injuries in Lilongwe, Malawi and to identify risk factors for severe injuries. Cross-sectional study of all adult pedestrian and cyclist injuries presenting to a large central hospital. This was a sub-study of a larger study with all types of road users included. All patients provided detailed information about the incidents leading to injury and were tested for alcohol. There were 222 pedestrians, 183 bicycle riders and 42 bicycle passengers among the 1259 adult road traffic injury victims that were treated at Kamuzu Central Hospital during a 90-day period in 2019. Of these injuries, 60.2% occurred while the victim was walking/cycling along the road and 22.3% when the victim was trying to cross the road. The majority of the victims were men (89.1%). Helmet use for bicyclists was almost non-existent. Only 1 patient had used reflective devices when injured in the dark, despite 44.7% of these injuries occurring in reduced light conditions. There was an increased risk for serious and fatal injuries for pedestrians compared with bicyclists, and also compared with all types of road users. Patients injured in rural areas and those hit by lorries were more severely injured. Consuming alcohol before being injured was associated with more severe injuries in bicyclists. Being injured while crossing the road at painted zebra crossings was associated with an increased risk of serious and potentially fatal injuries. This study identified important risk factors for severe injuries in pedestrians and cyclists. Implications for preventive measures are presented in a Haddon Matrix.