Characteristics and crash related behaviour of vulnerable road users presented to emergency departments

Vulnerable road users, namely, motorcyclists, bicyclists and pedestrians, contribute significantly to morbidity and mortality rates for road casualties. Many of these injuries occur off-road without police attendance or do not involve a collision with a motor vehicle. As a result, the magnitude and scope of their injuries are often underestimated. Behavioural factors also play a pivotal role, but information on the prevalence of behaviours related to an increased risk of involvement in a crash is also rather limited. A six-month prospective study of vulnerable road users presenting to emergency departments due to an injury from a crash or non-motor vehicle collision was conducted in Perth, Western Australia. Through a structured questionnaire, the characteristics of the road user, the injury sustained and the crash were described and the crash-related behaviour investigated. Of the total 392 vulnerable road users, 282 (72%) participated in the interview with the majority being bicyclists (53%) followed by motorcyclists (37%). Males represented 80% of the presentations and dominated each road user type except pedestrians. Many bicyclists and motorcyclists were injured by a collision that did not involve a motor vehicle and/or occurred in off-road situations and was not attended by police. In terms of behavioural factors, 30% of pedestrians reported the motor vehicle involved was moving faster than initially thought, particularly among older adults aged 55 and above. The study found that 7% of motorcyclists and 23% of bicyclists were not wearing their helmet at all times, while one third of the adolescent bicyclists did not wear a helmet at the time of injury. Only 20% of bicyclists and 67% of motorcyclists injured during the evening were wearing visible clothing. Overall, 14% of vulnerable road users admitted being distracted and 13% of them were hurrying before the injury event. Excessive speed was a contributing factor in crashes sustained by motorcyclists. In conclusion, data linkage between emergency presentations, hospital admissions and police records is recommended to improve the accuracy and representativeness of injury data. Behavioural factors play a pivotal role in the protection of vulnerable road users. Their safety, to a large extent, is determined by their risk taking behaviour. Safety promotion programs targeting the wearing of helmet and visible clothing should be aimed at both motorcyclists and bicyclists, especially among adolescent bicyclists.