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Abstract
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During the first decade of Action for Road Safety 2011–2020, a programme promoted by the United Nations, the number of deaths in road traffic decreased by 37% in the EU, but serious injuries only decreased by 14%, despite the goal to reduce deaths and injuries by 50% world-wide (European Transport Safety Council, 2021; United Nations General Assembly, 2015). Approximately one third of EU road deaths in motor-vehicle crashes occur in single crashes, and death rates have fallen a bit more slowly than road deaths caused by multi motor-vehicle collisions (European Transport Safety Council, 2017). Furthermore, the definition of single-vehicle crashes presupposes a vehicle (Mindell, 2017), despite the fact that most injuries in single crashes affect cyclists or pedestrians, with single-pedestrian crashes being termed pedestrian falls (Amin et al., 2022; Schepers, den Brinker, Methorst and Helbich, 2017). At least two reasons justify extending the definition of single crashes. First, there is an increase in calls to promote walking and cycling for environmental reasons and to reduce physical inactivity (Guthold et al., 2018; World Health Organization Europe, 2022). The government of Sweden, for example, is emphasizing development of infrastructure that stimulates increased walking and cycling (Swedish Transport Administration, 2021a). Secondly, although road traffic fatalities have decreased for motor vehicles in single crashes (European Transport Safety Council, 2017), the incidence of serious injuries among unprotected road users in a regional area of urban Sweden more than doubled between 2003 and 2014, and single crashes involving unprotected road users in other European countries also increased (Methorst et al., 2016; Næss et al., 2020; Värnild et al., 2019). Given that the vast majority of single-crash injuries involve cyclists and pedestrians (Amin et al., 2022; Eriksson et al., 2022; Schepers et al., 2015, 2017) the road space where road crashes are defined, should include not only roads but also tracks and pavements.
Like in multi-crashes, serious injuries sustained in single crashes result from the body being subjected to more energy than it can tolerate (Haddon, 1970). The localization of injuries in different body regions reflects where the energy generated in the crash impacted the body. Injuries from single crashes can occur due to deficiencies in maintenance and design of the road space or the vehicle (Hosseinpour et al., 2021; Elvik and Bjørnskau, 2019). They may also be caused by mistakes or deliberate misconduct (Larsson et al., 2010; Tingvall and Haworth, 1999).
Nevertheless, research on single road crashes that also includes cyclists and pedestrians is rare, and published studies focus predominately on single modes of transport (Klanjčić et al., 2022). For example, speed is important for both the number of crashes and the severity of injuries (Elvik et al., 2019). In a study from Ireland about the impact of speed on injuries for different types of motor vehicles, speeds of 80 or 100 km/h were compared with 50 km/h, and single crashes showed a smaller increase in the probability of mortality and serious injuries than multi-crashes (Donnelly-Swift and Kelly, 2016). In a Swedish study, the causes behind serious injuries sustained by cyclists in single crashes were examined. For 47% of the injured cyclists, the main cause of the crash was assessed to be deficiencies in the maintenance or design of the road space. For 27%, it was the cyclist's interaction with the bicycle or the bicycle's condition, and for 26% it was deliberate misconduct or mistakes, along with misjudgements in interaction with other road users (Niska et al., 2013). In another study about single bicycle crashes on roads in Australia, 32% of seriously injured cyclists were linked to crashes caused by faulty maintenance or road design (Beck et al., 2019). In a Swedish study of 20,943 single-pedestrian crashes, 55% of the injuries were linked to deficiencies in the maintenance (in terms of clearing snow, sanding, etc.) of a slippery surface mostly covered by snow or ice (Öberg, 2011). Similar results were found in a Norwegian study related to walked distance, with snow and ice on the surface being associated with a more than doubled risk of single-pedestrian crashes (Elvik and Bjørnskau, 2019). A Canadian study found that periods during winter with rain followed by sub-freezing temperatures generated at least twice the number of single-pedestrian crashes requiring ambulance intervention than the average for two winter months (Morency et al., 2012).
Less is known about single crashes also including falls than about different type of multi-crashes. This is the motivation of a study with focus on single crashes. The limitation to seriously injured road users is related to the Vision Zero policy: Noone shall be killed or seriously injured in road traffic (Tingvall and Haworth, 1999).
In this study the road space defines the road user, which implies an extended definition of crashes to include falls. The study will examine serious injuries from single crashes in Sweden during 2016–2019. The aim is to compare single crashes/falls across four modes of transport, including pedestrians, cyclists, car occupants and motorcyclists. Specific objectives include: What proportion of them received their injuries in single crashes? Do the injuries differ in terms of location in the body and severity? What impacts do sex, age and speed limit have on the injuries within and between the groups? ...
Language: en |