Source of head injury for pedestrians and pedal cyclists: Striking vehicle or road?

The potential effectiveness of vehicle-based secondary safety systems for the protection of pedestrians and pedal cyclists is related to the proportion of cases where injury arises by contact with the road or ground rather than with the striking vehicle. A detailed case review of 205 accidents from the UK On-the-Spot study involving vulnerable road users with head injuries or impacts indicated that contact with the road was responsible in 110 cases. The vehicle however was associated with a majority of more serious casualties: 31 (vehicle) compared with 26 (road) at AIS 2+ head injury level and 20 (vehicle) compared with 13 (road) at AIS 3+ level. Further analysis using a multivariate classification model identified several factors that correlated with the source of injury, namely the type of interaction between the striking vehicle and vulnerable road user, the age of the vulnerable road user and the nature of injury.