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- Meredith, Lauren, 1989, et al.
(author)
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Mapping fractures from traffic accidents in Sweden: How do cyclists compare to other road users?
- 2020
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In: Traffic Injury Prevention. - : Informa UK Limited. - 1538-957X .- 1538-9588. ; 21:3, s. 209-214
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Journal article (peer-reviewed)abstract
- Introduction: Cyclists account for a large share of injured road users in traffic. The crash data analysis for cyclist safety and protection should be based on a representative dataset of real-world crashes. This manuscript aimed to explore the patterns of cyclists’ fractures and factors associated with fractures of higher severity. Methods: This paper exemplifies a methodology that combines injuries from a crash database, including both hospital and police reports and fracture registry database from orthopedic centers nationally in Sweden. Results: Car occupants were most frequently involved in crashes resulting in fractures (37%), followed by motorcyclists (27.6%) and bicyclists (15.4%). Common fracture locations differed by the type of road user, where cyclists were more frequently fractured in the lower arm, compared to other road users, such as car drivers, motorcyclists and pedestrians who suffered mostly of fractures in the lower leg. Within cyclists, injuries also differed by gender, suggesting that combination of different countermeasures may be needed in order to provide sufficient protection for all cyclist. In the analyzed data, male cyclists with an average age of 49 were the most frequently fractured cyclists. Fractures of cyclists to the acetabulum (100%), pelvis (84.2%), vertebra (75%) and tibia (70.3%) were most frequently high energy fractures. Single bicycle incidents (OR = 0.165) and collisions with another bicycle (OR = 0.148) were significantly less likely to result in a high energy fracture than a collision with a car. Conclusions: The results of this study may guide the design of appropriate protective devices for the cyclists based on the different injury mechanisms and provide implications for prioritizing new countermeasures, campaigns, or regulations.
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- Rizzi, Maria C, et al.
(author)
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The potential of different countermeasures to prevent injuries with high risk of health loss among bicyclists in Sweden
- 2020
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In: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 21:3, s. 215-221
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Journal article (peer-reviewed)abstract
- Objective: As bicyclists account for the largest share of serious injuries in Sweden, focus to improve safety for bicyclists is needed. While knowledge about fatal bicycle crashes is rather extensive, the number of studies that have investigated non-fatal injuries is still rather limited. The aim of this study was to estimate the potential of different countermeasures to reduce crashes resulting in injuries with high risk of health-loss among cyclists in Sweden. A further aim was to describe the residual—that is, crashes that were not considered to be addressed by the analyzed countermeasures. Methods: A sample of individuals with specific injury diagnoses was drawn from the Swedish national crash database Strada. A survey form was used to collect additional information about the crash and the health-related outcomes. The potential of countermeasures currently included in the Swedish Safety Performance Indicators, as well as of countermeasures that could be described as “existing but not fully implemented” was assessed. The overall potential of all countermeasures assessed was calculated, giving a grand total without double counting. Cases that were considered not to be addressed by any of the countermeasures included (i.e., the residual crashes) were described in more detail. Results: The current Swedish Safety Performance Indicators that relate to safe cycling addressed 22% of crashes. Improved maintenance by deicing and removal of snow from bicycle infrastructure was found to have the highest potential (8%), followed by improved crashworthiness of passenger cars (5%) and safer bicycle crossings (4%). The potential for existing but not fully implemented safety improvements was 56%. The greatest potential was found for Autonomous Emergency Braking with cyclist detection for passenger cars (12%), followed by studded winter tyres for bicycles (12%), and improved maintenance on non-bicycle infrastructure (11%). In total, taking double counting into consideration, all safety improvements could address 64% of all crashes. Among the residual crashes, the majority (69%) were single bicycle crashes of which most were related to wheel locking during braking and losing balance at low speed or stationary. Conclusions: Compared with fatal crashes that involve a majority of bicycle-car crashes, the crashes leading to health-loss are mostly single bicycle crashes. Therefore, innovation and development of additional countermeasures to improve safety for bicyclists should focus on single bicycle crashes.
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- Stigson, Helena, 1979, et al.
(author)
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Health status and quality of life among road users with permanent medical impairment several years after the crash
- 2020
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In: Traffic Injury Prevention. - : Informa UK Limited. - 1538-957X .- 1538-9588. ; 21:S1, s. S43-S48
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Journal article (peer-reviewed)abstract
- Objective Improvements in road infrastructure and vehicle safety have been achieved in many countries during the last decades. As the number of fatalities have dropped, the consequences of non-fatal injuries have been brought into focus. Therefore, the objective was to investigate self-reported health status and health-related quality of life several years after the crash for road-users that sustained injuries resulting in permanent medical impairment (PMI). Methods A self-administered questionnaire using instruments to measure if health, health-related quality of life and physical activity had been affected by the crash, were used. The injured road-users were identified from insurance policy holders of the Folksam Insurance Group. The response rate was 29%, a total of 2078 responses were received from the 7174 road-users with PMI that received the questionnaire. Results In total 85% were still suffering from the injuries several years after the crash (8-18 year after the crash). Furthermore, road-users with injuries to the spine were having highest pain intensity. Older road-users had poorer self-reported health status than younger road-users. Although, younger road-users had the greatest change in physical activity when comparing before and after the crash. Before the crash in total 63% were physically active while only 34% after the crash. The higher the PMI the higher it affected health several years after the crash. Conclusions The Swedish definition of serious injury, an injury leading to PMI, was found to correlate with self-reported health loss; 85% of the injured road-users reported that they still had remaining symptoms several years after the accident. The injured body region leading to PMI after an accident can vary from the body regions reported to cause long-term health loss. It was found that the higher the degree of PMI the higher the health loss. Sustaining a PMI regardless severity and injured body region has the same effects on general health for men and women. Sustaining a PMI will both lower the health-related quality of life and physical activity after the crash compared to before.
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