Pedestrian injuries and vehicle type in Maryland, 1995–1999

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Abstract

Pedestrian deaths constitute the second largest category of motor vehicle deaths in the US. The present study examined how pedestrian injury is associated with vehicle type, while controlling for vehicle weight and speed.

Police, trauma registry, and autopsy data were linked for injured pedestrians. Logistic regression analyses were performed to control for vehicle weight and speed. Outcomes included pedestrian mortality, injury severity score, and injuries to specific body regions.

Compared to conventional cars, pedestrians hit by sport utility vehicles and pick-up trucks were more likely to have higher injury severity scores (odds ratio=1.48; 95% confidence interval: 1.18–1.87) and to die (odds ratio=1.72; 95% confidence interval: 1.31–2.28). These relationships diminished when vehicle weight and speed were controlled for. At lower speeds, pedestrians struck by sport utility vehicles, pick-up trucks, and vans were approximately two times as likely to have traumatic brain, thoracic, and abdominal injuries; at higher speeds, there was no such association.

The overall increased danger sport utility vehicles and pick-up trucks present to pedestrians may be explained by larger vehicle masses and faster speeds. At slower speeds being hit by sport utility vehicles, and pick-up trucks, and vans resulted in specific injuries, indicating that vehicle design may contribute to different injury patterns.

Introduction

Pedestrian deaths constitute the second largest category of motor vehicle deaths in the US. This category includes almost half of the traffic deaths for ages 3–9 and more than one-fourth for ages 75 and older (Baker et al., 1992). Among all motor vehicle trauma, the case-admission ratio is highest for pedestrians (266 hospital admissions per 1000 cases) (Barancik et al., 1986). In 1999 in the US, there were 85,000 pedestrians injured in traffic crashes, and 4907 pedestrians killed. This accounted for 12% of all traffic fatalities, but only 3% of all traffic injuries. On the average, in the US a pedestrian is injured every 6 min and one is killed every 107 min (National Highway Traffic Safety Administration, 1999).

In 1999 the state of Maryland had a pedestrian fatality rate of 2.2 per 100,000 population., which is 22% above the national average and ranks as the eighth highest among states in the US (National Highway Traffic Safety Administration, 1999). Nearly one-fourth of people killed in traffic accidents in the Baltimore area are pedestrians, an urban rate that is among the highest in the nation (Meyers, 2000).

Compared to vehicle occupants, less attention is paid to reducing pedestrian deaths and injuries. When countermeasures are devised, the focus is mostly on pedestrians’ behavior, even though drivers are often at fault (Insurance Institute for Highway Safety, 1999). While many issues including pedestrian and driver behavior, as well as environmental factors, influence the occurrence and severity of pedestrian injury, an important but often overlooked factor is the vehicle. With the recent rise in popularity of sport utility vehicles (SUVs) and minivans, the issue of vehicle type is becoming more relevant to pedestrian safety. The purpose of this study was to determine if pedestrian injury is associated with vehicle type while controlling for vehicle weight and speed.

Section snippets

Inclusion/exclusion criteria

The present study involved pedestrians injured in the state of Maryland from 1995 to 1999. Pedestrians had to have been struck by either a conventional car (sedan, coupe, sports car, station wagon, and hatchback), sports utility vehicle, pick-up truck (PU), or van. In addition, pedestrians had to either have been treated at a Maryland trauma center or have died as a result of their injuries.

Sources of data

Vehicle type was determined using the Maryland Automated Accident Reporting System (MAARS) database

Results

From 1995 to 1999, there were an annual average of 3368 Maryland pedestrians involved in police-reported traffic collisions and 107 pedestrians who died as a result of their injuries. This resulted in a case incidence rate of 66.1 pedestrians hit per 100,000 population, case fatality rate of 2.1 per 100,000 population (or 3.17%), and a case fatality rate of 3.17%. Across this 5-year study period, there was an 8.9% decrease in the incidence rate and a 20.1% decrease in death rate.

Discussion

While a few epidemiologic studies on pedestrian injuries have commented on vehicle type, the classifications have been extremely broad (e.g. motor vehicles, bicyclists, and other) (Galloway and Patel, 1982, Atkins et al., 1988, Harruff et al., 1998, Kingman, 1994). In general these studies only described the distribution of vehicles, rarely examined specific pedestrian injuries by vehicle type, and never studied the relationship between pedestrian injury and vehicle type while controlling for

Conclusions

Pedestrians hit by SUVs and pick-up trucks were more likely to have more severe injuries and more likely to die, but the increase in danger may be explained primarily by larger vehicle weights and faster vehicle speeds. Regardless of vehicle weight, pedestrians struck at slower speeds by SUVs, pick-ups, and vans incurred a rate of brain, thoracic, and abdominal injuries twice that of those struck by conventional cars, indicating that vehicle design may contribute to different patterns of

Acknowledgements

We would like to thank John New and Claudine Woo from the Maryland Institute for Emergency Medical Services Systems; the late Dr. John Smialek, Dr. David Fowler, and Donna Hanson from the Office of the Chief Medical Examiner; Doris Byrne from the Maryland State Archives; Ida Williams from the Central Records Division of the Maryland State Police; Daniel Vomhof from 4N6XPRT Systems; Shiu Ho from the Charles McC. Mathias National Study Center for Trauma and EMS; and the late Dr. Trudy Bush, Dr.

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