Study on serious road traffic injuries in the EU

Aarts, L.T.; Commandeur, J.J.F.; Welsh, R.; Niesen, S.; Lerner, M.; Thomas, P.; Bos, N.; Davidse, R.J.

It is the ambition of the EU to reduce the number of killed and seriously injured on the roads over time. It has turned out that, especially in relation to serious injuries, there is still a significant knowledge gap on how to reduce these numbers in the EU. The Commission is therefore committed to develop a particular focus on the serious road traffic injuries, to better understand their causes and effects. One of the first actions the Commission has undertaken is to develop a common definition of ‘serious traffic injury’ within all Member States as injuries scoring 3 or more on the medical Maximum Abbreviated Injury Scale (MAIS3+). While the EU Member States are proceeding in estimating the total number of serious injuries for their country, there is the need to know more about main crash circumstances of MAIS3+ casualties in order to make a start with the formulation of strategies and measures that are effective in the prevention of these injuries.

Aim of this study

The general objective of this study is to collect knowledge that will enable the future identification of measures for effective prevention of serious road traffic injuries. The specific objective is to provide fact-based analysis on the most common circumstances and types of road traffic crashes leading to serious injuries of MAIS3+ severity. More specifically, the study is directed at providing an understanding of the main circumstances and factors that affect the emergence of serious road traffic injuries, medically coded as MAIS3+, for the following road traffic modes in the EU: pedestrians, bicyclists, motorcyclists and car occupants.

Approach of the study

The study has been performed on data of MASI3+ cases linked with crash information, which was available for the following countries: Austria, Czech Republic, France, Germany, Italy, Netherlands, Spain, Sweden and England. Data are gathered from in-depth sources, hospital discharges, trauma registers and police records linked to medical registers.
For each database, the available main crash characteristics have been extracted and used to define common scenarios for each traffic mode. Also the most affected body regions of the severely injured casualties have been gathered per traffic mode and per database. Furthermore, differences in injury patterns per crash scenario have been studied in order to find first clues for effective measures.

Results of the study

Most common characteristics of crashes with severely injured pedestrians:

  • Gender: about equal division between male/female;
  • Age: elderly people and children;
  • Crash opponent: cars and heavy vehicles;
  • Location: urban 50 km/h road section;
  • Time: afternoon and winter months;
  • Contributing crash factors: looking or judgement failures, speed-related and psychoactive substances;
  • Head and upper body injuries: heavy vehicles and higher speed roads;
  • Lower extremity injuries: cars and lower speed roads.

Severely injured bicyclists have the following common characteristics:

  • Gender: slight to heavily male dominated;
  • Age: elderly, youngsters, middle aged, children;
  • Crash opponent: car, no crash opponent;
  • Location: urban area, 50 km/h, intersections;
  • Time: summer, afternoon;
  • Contributing crash factors: failures in looking or judgement, reckless driving and loss of control;
  • Head injuries: dominant in all crash scenarios;
  • Lower extremity injuries: single vehicle crashes, elderly people and crashes with lower impact speed;
  • Thorax injuries: side-impact crashes in urban areas and at junctions.

Common characteristics of severely injured motorcyclists are:

  • Gender: >90% male;
  • Age: youngsters and middle aged people;
  • Crash opponent: car, no opponent, fixed objects;
  • Location: rural and urban roads;
  • Time: summer and spring;
  • Contributing crash factors: failures in looking or judgement, speeding and loss of control;
  • Thorax injuries: single, fixed object, rural areas;
  • Lower extremity injuries: car crash.

Common characteristics for severely injured car occupants:

  • Gender: two thirds males;
  • Age: youngsters;
  • Crash opponent: cars, no opponent and fixed obstacles;
  • Location: rural roads, speeds >70 km/h;
  • Time: afternoon and winter months;
  • Contributing crash factors: loss of control, speeding and psychoactive substances;
  • Thorax injuries: car to car, wearing seat belt but no airbag available;
  • Head injuries: crash with fixed object and heavy vehicles, not wearing a seat belt and no airbag available;
  • Lower extremity injuries: car to car crashes, also in lower speed zones.

A first comparison with main features of fatal crashes in the EU has revealed that the MAIS3+ results are probably quite representative for the entire EU, although it is expected that there will be country specific differences, as was also found in some results in this study (e.g. differences in travel purposes of certain traffic modes like two-wheelers resulting in particular crash characteristics, differences in share of road types and differences in shares of crash opponents which may be influenced by modal split, travel behaviour and country characteristics). Injury patterns seem to be largely influenced by these crash characteristics.


Although this study was not directed at defining effective measures to prevent serious injuries, the findings provide support that a number of measures that are known to be effective for the prevention of fatal crashes could also help reduce serious injuries. A more detailed study of the causes of serious road injuries, linked to the actual policy and the state of the road traffic system in Member States, could reveal more specific keys to reduce the number of serious injuries in the EU.

Policy recommendations at EU level are to help Member States in creating awareness of the specific characteristics of MAIS3+ casualties and tune their policy to the prevention of these crashes. Research into effective measures is therefore a next important step. Defining a severe injury target could help to increase awareness, information gathering and policy efforts directed at the reduction of serious injuries. Benchmarking between Member States can provide further opportunities to learn from each other.

European Commission, Brussels

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