Sweden has a new legislation since 2003 stating that all public places and areas must be accessible to older people and people with disabilities. As a consequence, new regulations was launched “easily removed obstacles in the outdoor environment” stating that certain specifically mentioned obstacles in the outdoor environment must be removed before year 2010. This law is valid for both already existing environments as well as new built areas. The aim of this paper is to describe the frequency and causes of falls as pedestrians among older persons (65+) and relate these to known and reported accessibility barriers in the outdoor environment. The method used is firstly STRADA (The Swedish Traffic Accident Data Acquisition). In Sweden traffic injuries is recorded via hospital registrations as a complement to police reported accidents. In the southern part of Sweden (the Region of Skane) 8 hospitals are responsible for this registration. Secondly, a postal questionnaire to 556 older persons in a geographical defined area in Kristianstad (a city in the Region of Skane) was conducted to investigate accessibility barriers. When analyzing the registered injuries, the most common accident among older persons is falling down. Among older persons (65 and over) a total of 3349 pedestrians were killed or injured and 3057 (91%) were single accidents during 2000-2004. When dividing the older population into subgroups the proportion of single accidents is equal for the two age groups 65- 74 respectively 75-84, i e 92%, whilst for the oldest segment of the population, 85 and over, the share of single accidents is decreasing, 87%.The cause is poorly maintained sidewalks and pathways – summer and winter. In numerous studies in Sweden and elsewhere, uneven pavements, pot-holes, slippery roads badly designed curb-cuts are frequent reported environmental barriers affecting both the accessibility and mobility of older persons. In the postal questionnaire a total of 338 persons responded and 20% claimed that it was difficult to get around as a pedestrian in the local neighbourhood. A good fifteen percent defined high curb-stones, holes or deterioration in walking surfaces on pathways/sidewalks, as well as uneven, narrow sidewalks with severe grades as environmental barriers. In conclusion, there is a strong relationship between the barriers that older persons report in their neighbourhood and the reported causes to the injuries i.e. a relation between the accessibility level of the environment and the traffic safety risk. Good maintenance strategies of pedestrian areas and the removal of obstacles according to the law, have good potentials for increasing the safety, accessibility and mobility of older persons. Hence it is important to prioritize falls among pedestrians in local traffic safety planning. A decrease in the number of falls is a valid indicator of increased accessibility in the area and in the fulfilment of the Swedish law. Likewise a fulfilment of the regulations of easily removed obstacles in the environment will most likely reduce the falls as pedestrians among older people in the long run. (Author/publisher) This publication may be accessed by Internet users at: http://www.ictct.org/workshop.php?workshop_nr=25
Abstract