Objective: To investigate the burden of pedestrian injuries, including pedestrian fall injuries (PFI), compared to other transport-related injuries in Sweden and document their characteristics in terms of demographics, causes, type of injuries, and severity level with a focus on long-term consequences. Methods: Data were retrieved from the national Swedish Traffic Accident Data Acquisition register. A total of 361,531 fatalities and injuries were reported by emergency hospitals during 2010–2019, of which 127,804 were pedestrians (35%). We assessed the magnitude of PFIs and conducted comparative analyses to assess differences compared to other types of road users regarding sex, age, severity level, injury circumstances, hospital care, causes of accidents, and type of injuries. Results: Pedestrians were the second largest group of traffic-related deaths in Sweden after car occupants and accounted for just over a quarter of all fatal accidents in the road traffic environment. Of the total number of pedestrian fatalities, three out of four have been in collision accidents and the others in fall-related accidents. In terms of injuries, pedestrians were the largest group among all road users, regardless of the type of accident. PFIs accounted for a third of all injuries in the road traffic environment and nearly half of all injuries resulting in permanent medical impairment (i.e., 2.2 times more long-term consequences among PFIs compared to injured car occupants). Females (particularly middle-aged and older) and older adults were overrepresented, and most PFIs occurred on urban and municipal roads. The causes were often related to maintenance (e.g., slippery surfaces such as ice, snow, leaves or gravel together with uneven pavements and roads are the cause three out of four of PFIs). Among collision injuries, the representation was almost equal for sex and age. Conclusions: Injuries and fatalities among pedestrians are a considerable issue in the road traffic environment in Sweden. Contrary to other traffic groups, the incidence has not decreased over time, meaning that this issue must be met with specific measures and address the specific risk factors they are associated with. Practical Application: Including fall accidents in the definition of traffic accidents increases the chances of getting better information about the accidents and taking preventive measures.

ObjectivesIn contemporary urban environments, the intersection between Vulnerable Road Users, specifically unprotected pedestrians, and motor vehicles poses a persistent challenge to road safety. Reversing accidents, characterized by vehicles moving backward, often result in severe consequences for pedestrians due to limited visibility and inherent blind spots for the driver. This paper aims to provide a thorough examination of reversing accidents involving pedestrians in Sweden between 2000-2021; shedding light on the magnitude of the problem, contributing factors, consequences, and potential mitigation strategies.MethodUsing a national database, reversing accidents were compiled by classifying free text descriptions of traffic accidents reported to the Swedish Traffic Accident Data Acquisition. The database was then used to describe reversing accidents and their consequences for struck pedestrians using descriptive epidemiology and cluster analysis.ResultsThe results show that reversing accidents accounted for 12% of all pedestrians injured in a collision with a motor vehicle in Sweden during the studied period. In terms of personal characteristics, the struck pedestrians were more often female and of old or young age, whilst the drivers of the reversing vehicles were more often between 18-54 years and men. Most accidents were non-fatal, with only roughly 2% resulting in fatalities. Through a cluster analysis, four distinct accident types were identified. Two of these were identified as particularly important to prioritize in future preventative work: accidents that are characterized by occur during daylight hours in the urban environment (often low speeds) and often result in fatality or serious injury.ConclusionsDue to the low speeds, reversing accidents are rarely fatal. However, they account for a large proportion of accidents with pedestrians and can be grouped into clearly distinguishable accident types that can function as templates in road safety development in Sweden.

Objective:  The aim of this study is to investigate the effectiveness of Automatic Emergency Braking (AEB) with detection of pedestrians and bicyclists in reducing car-to-pedestrian and car-to-bicyclists collisions and also injury mitigation in these collisions.

Methods: The study analyses collision data from the Swedish Traffic Accident Data Acquisition (STRADA) encompassing road traffic accidents reported by the police and by emergency hospitals in Sweden. Crashes occurring between the years 2012 and 2022 and with cars from model years 2012 to 2022 were included in the dataset. Two statistical analyses were performed. To evaluate the crash reduction effect of AEB, odds ratio calculations with an induced exposure approach was conducted where the outcomes of sensitive and non-sensitive crashes were studied. The sensitive crashes were hit pedestrians and bicyclists, respectively. The non-sensitive crash type in both comparisons was struck vehicles in rear-end crashes. The collision reducing effect was analysed for various speed limits, lighting and visibility conditions. To evaluate whether AEB has a reducing effect on injury severity, relative differences in injury outcomes (both proportion of MAIS3+ and risk of permanent impairment, RPMI) of pedestrians and bicyclist was compared for hitting cars with and without AEB.

Results: A total of 2,160 pedestrian collisions and 3,374 cyclist collisions were included, and the non-sensitive crashes consisted of 5,738 vehicles. The overall reduction in crash risk was approximately 20% (±10%) for vehicles equipped with AEB with pedestrian and/or bicycle detection. When analysed by lighting conditions, reductions in crash risk of just over 20% were observed in daylight for vehicles with AEB with pedestrian and/or bicycle detection. It appears to be a reduction also in darkness, although the reductions found of approximately 20% were not statistically significant. Reductions were observed for various weather conditions, except for cyclist crashes during rain, fog, and snowfall. A greater reduction in crash risk was noted on high-speed roads (60–120 km/h) for vehicles equipped with AEB for bicycle detection compared to low-speed roads (10–50 km/h). No similar difference was observed for AEB with pedestrian detection. Additionally, there was a greater reduction in crashes at intersections for vehicles with AEB for pedestrian detection and on roads for vehicles with AEB for bicycle detection. No difference in injury severity, both regarding proportion of MAIS3+ and RPMI, for both pedestrians and bicyclists was observed between collisions involving vehicles with and without AEB.

Conclusions: This study confirms the significant potential of AEB systems in improving road safety for pedestrians and cyclists. However, their current effectiveness is too low to provide sufficient protection at today's speed limits and their expected potential and real-world performance differ a lot, which highlights the need for improvements. The study shows varying effectiveness of AEB systems in reducing crash risks under different lighting, weather, and speed conditions. Furthermore, no injury mitigating effect could be verified for cars with AEB for pedestrians and bicyclist might indicate that either a crash was completely avoided, or the AEB system did not perform any braking. While avoiding crashes could be the prime objective for an AEB for vulnerable road users, braking that reduce injury severity despite there was a crash is of importance as well.

In Sweden, falls amongst pedestrians during wintertime, due to slipping on ice and snow, is a costly and growing problem. Using data on pedestrian falls from four Swedish cities, the injury-reducing effect of heated surfaces was studied. The results indicate that heated surfaces have a significant injury-reducing effect especially in cities with more ice and snow. Currently, district heating is used as a heat source and at an increasing cost. By using GSHP systems as a heat source, the cost could be considerably lowered, and in this way secure the further use and expansion of heated pedestrian paths.