Injury events among bus and coach occupants - Non-crash injuries as important as crash injuries

• A ten year complete data set from the health sector, comprising 284 injured bus and coach occupants from a well defined area, was analyzed. The annual injury incidence was 2 per 10,000 inhabitants, 3/4 were women. In non-crash incidents, 54% were injured; 2/3 while alighting from a bus or coach. In crashes, 46% were injured; 2/3 in collisions with other vehicles and 1/3 in single vehicle crashes. During October-March, 3/4 were injured.　In two single vehicle mass casualty crashes in slippery road conditions, high built coaches were hit by so high cross wind forces that they were blown off the road. This crash mechanism has received little attention earlier. Of those injured in collisions with other vehicles, 78% were injured in collisions with other heavy vehicles. Slippery conditions contributed to half of the alighting injuries. The proportion of moderate or more serious injuries (MAIS 2+) was highest in single vehicle crashes (48%) and in alighting and boarding (43%) incidents, and was lowest (5%) in collisions. Every seventh injured was treated as an in-patient on average in five days. Non-crash victims consumed 57% of all in-patient days.　Conclusions: The aerodynamic cross-wind factor merits more studies. Injury reducing measures against alighting injuries, addressing especially step height and slippery conditions, may have a great potential to reduce these injuries. Rear-end collisions by other heavy vehicles in urban areas, causing a high number of “whip-lash" injuries, also need to be further addressed. The newly introduced law on compulsory seat belt use in long distance coaches may have a potential to reduce single vehicle crash and some collision injuries.

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