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What types of injuries did seriously injured pedestrians and cyclists receive in a Swedish urban region in the time period 2003–2017 when Vision Zero was implemented?
Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.ORCID-id: 0000-0002-1831-1400
Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.ORCID-id: 0000-0002-3787-1040
Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Karolinska Institutet, Sweden.ORCID-id: 0000-0002-3452-7260
2020 (Engelska)Ingår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 181, s. 59-64Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives

The aim of the study is to examine what types of injuries that seriously injured pedestrians and cyclists received in urban road spaces from 2003 to 2017 in the Swedish region of Västmanland, when the road safety policy Vision Zero was implemented.

Study design

This is a cross-sectional data annually collected over a period of fifteen years.

Methods

Data from health care for 403 seriously injured pedestrians and cyclists were retrieved from the registry STRADA (Swedish Traffic Accident Data Acquisition) and cross-referenced with the National Road Database to see if any Vision Zero measures had previously been implemented at the crash location. The study includes injuries from both single and multiple crashes on roads, pavements, and tracks for walking and cycling (road space). Statistical analysis was performed by descriptive statistics, chi-square tests, and multiple logistic regression analyses.

Results

Pedestrians were seriously injured in lower extremities more than cyclists, whereas more cyclists were seriously injured in the head. During the period, pedestriansꞌ head injuries decreased significantly, but injuries in lower extremities increased significantly. In addition, for cyclists, there was a shift from decreased probability of head injuries to increased probability of injuries in lower extremities related to increased age. For pedestrians, pavements/tracks were associated with a decreased probability of a majority of injury outcomes but for cyclists only for severe injury outcomes.

Conclusions

From 2003 to 2017, there was a shift among seriously injured pedestrians, with head injuries decreasing and injuries in lower extremities increasing. This shift was probably related to an ageing population in the region, given that increased age among both pedestrians and cyclists was associated with a decreased probability of head injuries but increased probability of injuries in lower extremities. On Vision Zero roads, there was a decreased probability of pedestrians receiving serious injury to more than one bodily region. An increased number of older people combined with policies for more active mobility such as walking and cycling are a challenge for road authorities in urban areas.

Ort, förlag, år, upplaga, sidor
2020. Vol. 181, s. 59-64
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:mdh:diva-46787DOI: 10.1016/j.puhe.2019.11.019Scopus ID: 2-s2.0-85077913357OAI: oai:DiVA.org:mdh-46787DiVA, id: diva2:1387956
Anmärkning

©2019 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is anopen access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Tillgänglig från: 2020-01-23 Skapad: 2020-01-23 Senast uppdaterad: 2020-04-30Bibliografiskt granskad
Ingår i avhandling
1. Seriously injured road users in rural and urban road traffic in a Swedish region - a Vision Zero perspective
Öppna denna publikation i ny flik eller fönster >>Seriously injured road users in rural and urban road traffic in a Swedish region - a Vision Zero perspective
2020 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Globally more than 50 million people are injured in road traffic every year. The incidence of road injuries is increasing while that of fatalities is decreasing. Road safety measures are being implemented in many countries to reduce the effects on public health. In highly motorized countries, the process is often managed by quantitative targets. Sweden has a target for 2020 based on Vision Zero: that no-one should be killed or seriously injured in road traffic. In Vision Zero, pedestrians in single crashes are not defined as road users, even when they move in the same areas as road users with vehicles. In this thesis the road space (pavements, tracks and roads) defines the road user.

The aim of the thesis is to study the development of serious injuries in rural and urban areas during a period when Vision Zero was being implemented through government efforts to direct the process in Sweden. The thesis adopts a regional perspective. Three of the four studies in the thesis are cross-sectional studies with data from Region Västmanland during twelve to fifteen years, 2003–2017. Data are also based on analyses of ten regional infrastructure plans in Sweden for the period 2014–2025.

On national roads in the region, the incidence of serious injuries decreased for car occupants, but on regional roads it increased. In urban areas the incidence for unprotected road users doubled on roads and more than doubled on tracks and pavements where the greatest number of unprotected road users are seriously injured. One factor in the increased incidence is the growing number of elderly people in the population caused by the large generation born in the 1940s and a lengthening lifespan. From 2012 the probability of being seriously injured increased for cyclists and pedestrians 80 years and older, and from 2015 for the group 65 years and older.

In urban areas during the period, there was a shift in serious injuries for pedestrians and cyclists from less head injuries to more injuries in lower extremities. The probability of receiving serious injuries to the lower extremities increased fourfold from the age of 50 for both pedestrians and cyclists, but for cyclists the probability increased with age.

For pedestrians, pavements and tracks were associated with decreased probability of all injuries except for head injuries, but for cyclists this decrease is only seen for the most severe injuries. For pedestrians, the probability of getting injuries in more than one bodily region decreased on Vision Zero roads.

Prioritized investments in regional plans are mostly justified by accessibility and increased walking and cycling, and only more sparsely by road safety. This reflects an imbalance in the government’s clarifications of the transport goals.

In directives for regional planning and in support of the objectives of Agenda 2030, the government has argued for more active mobility. There is a need to include pedestrian falls in the category of single crashes in the work with Vision Zero. Increased walking and cycling justifies more road safety measures especially in urban areas in order to achieve the targets of Vision Zero. To achieve Vision Zero it is important that the concerned road authorities and regions are committed to the goals and fulfil their tasks. More active mobility in combination with an increased number of older people is a challenge for municipalities as road authorities in urban areas.

Ort, förlag, år, upplaga, sidor
Västerås: Mälardalen University, 2020
Serie
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 312
Nyckelord
Vision Zero, road injuries, rural, urban, cyclist, pedestrian, policy, management by objectives
Nationell ämneskategori
Medicin och hälsovetenskap Hälsovetenskaper
Forskningsämne
folkhälsovetenskap
Identifikatorer
urn:nbn:se:mdh:diva-47553 (URN)978-91-7485-464-0 (ISBN)
Disputation
2020-06-10, Sal Beta, Högskoleplan 1, Västerås, 13:00 (Svenska)
Opponent
Handledare
Forskningsfinansiär
Trafikverket, TRV 2014/49856
Tillgänglig från: 2020-04-23 Skapad: 2020-04-22 Senast uppdaterad: 2020-05-19Bibliografiskt granskad

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