The purpose of this study was to investigate changes in the incidence and consequences of car-pedestrian accidents in urban traffic during a ten year period. The study compared the type and severity of the injuries recorded at the hospitals in Gothenburg (Sweden) during 1983-1986 and 1993-1996. The study focused on accidents where the pedestrian was hit by the front part of a car or taxi. The circumstances of the accidents and the impact speed were deduced from police reports. The shape and dimensions of the impacting structures were determined from standardised drawings of the vehicles. Comparing the two time periods, the number of accidents reduced by 38%. The average Injury Severity Score (ISS) reduced overall, especially in children (50%) and the elderly (39%). The occurrence of serious, severe, critical, and fatal injuries (Abbreviated Injury Scale (AIS) 3+) decreased in all regions of the body, and also the distribution of the injuries changed. Serious or more severe injuries became more frequent in the head and chest and less frequent in the knee and lower leg during the later period. The percentage of the injured with severe fractures of the knee or lower leg decreased significantly. The main reasons for these differences are probably a reduced car-traffic intensity and a reduced traffic speed within the central part of the city. However, such changes cannot explain all the differences, and it is concluded that changes in car design between the two time periods may have an influence too. (A)
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