Looking both ways at the significant dangers to pedestrians in wheelchairs
Thursday, June 28, 2018
Traffic crashes are a leading cause of death worldwide. Pedestrians; those who travel by foot or wheelchair, are the most vulnerable of those who share roadways with vehicles.
A recent report from the Governors Highway Safety Association (GHSA) estimated that close to 6,000 pedestrians were killed in motor vehicle crashes in 2017. The report discusses factors contributing to the increasing numbers of fatal pedestrian injuries, including the legalization of marijuana and growth in the use of smartphones as contributors.
Those states having legalized the adult use of recreational marijuana between the years of 2012 and 2016 had an increase of fatal injury to pedestrians at a rate of 16.4 percent for the first six months of 2017. Meanwhile, those states not having legal adult use of marijuana had a decrease of 5.8 percent.
Those pedestrians using wheelchairs suffer fatal injury when hit by a vehicle at a rate that is close to 40 percent greater than the general population. More than half of fatal injuries to wheelchair users occur in intersections.
It is out of the ordinary for records related to fatal injury to pedestrians to record the use of a wheelchair even when it is evident. The actual rate of fatal injury is unknown, as use of a wheelchair in the fatal injury of a pedestrian is not required to be reported.
The National Highway Traffic Safety Administration (NHTSA) estimates 28 wheelchair pedestrians suffer fatal injury every year. Since that data is not kept, it is not known if the rate of fatal injury to wheelchair users is also increasing.
A review of emergency room data between 2002 and 2010 found that an estimated 9,348 people utilizing wheelchairs were treated in hospital emergency rooms for pedestrian injuries that were not fatal.
Contusions, abrasions and lacerations accounted for 42 percent of injuries, and fractures 16 percent. Head and neck injuries were reported at a rate of 25 percent, with lower extremities at 28 percent.
Twenty percent of those injured required hospitalization. Ninety percent of the vehicle crashes injuring wheelchair pedestrians occurred in traffic on public roadways.
A study that recorded driving behaviors and patterns determined the aspects of crashes and near-crashes using video from 3,546 participants driving in the United States of America, which means right-side traffic directionality. The records included 1,465 crashes and 2,722 near crashes.
During crashes and near-crashes the location of hit was most often on the front side of the driver participant’s vehicle. The videos indicated that crashes were 1.41 times as likely to occur on the left compared to the right side of participants' vehicles.
Another study undertaken by the NHTSA’s Pedestrian Crash Data Study from 1994 to 1998 looked at crash evidence related to car hoods and pedestrian injury. It had data from 97 cases with pedestrians having 270 injuries from 141 unique hood contact locations. The study found that 36 percent of hit points were on the left, 28 percent center and 36 percent to the right on the hood.
Regarding the study that found wheelchair users at greater risk for fatal injury than the general population, the lead scientist, John Kraemer, JD, MPH, assistant professor of health systems administration at Georgetown’s School of Nursing and Health Studies and a scholar at the university’s O’Neill Institute for National and Global Health Law commented, “A high proportion of crashes occurred at locations without traffic controls or crosswalks. When there is poor pedestrian infrastructure or it’s poorly adapted to people with mobility impairments, people who use wheelchairs often are forced to use the streets, or are otherwise exposed to greater risk. It also may be telling that, in three-quarters of crashes, there was no evidence that the driver sought to avoid the crash.”
With drivers afflicted by ever-increasing dangerous habits and behaviors, such as driving under the influence of marijuana, other drugs or alcohol, and the use of distracting technology, all pedestrians are at risk for harm.
The state of Washington reviewed fatal crash data before, during, and after legal adult use of recreational marijuana. It found that when there was a fatal crash and the driver tested positive for only active marijuana, indicative of recent use within hours, that the fatal injury likelihood to pedestrians, bicyclists, other drivers and passengers was six times that of those having been in a fatal crash but having only consumed alcohol. Colorado is identifying an increased rate of pedestrian and bicyclist fatal injury since the legalization of adult use of marijuana.
Wheelchair pedestrians have much at stake, as groups develop strategies to research and understand distracted and impaired driving, yet are rarely included in committees or commissions that develop the strategic initiatives.
No driving impaired committee or commission in those adult use recreational marijuana states has representation from the wheelchair community, and newer committees do not even include representation from victims’ groups.
In researching wheelchair pedestrian risk, Kraemer further commented, “Understanding and describing risks are the first steps to reversing them. While there was a little data on non-fatal pedestrian injuries among people who use wheelchairs, there were almost none on fatal injuries.”
We will not gain understanding of how to prevent injury and fatalities among those with wheelchairs if they are not included in the discussions.
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