Hazard
(Edition No. 72)
Summer 2010/11
Victorian Injury Surveillance
Unit (VISU)
www.monash.edu.au/muarc/visu
Monash University
Accident Research Centre
Traffic-related pedestrian injury in
Victoria (2): Fatal injury
Erin Cassell, Emily Kerr, Nicolas Reid, Angela Clapperton, Hafez Alavi
This is a companion edition to Hazard 71 in which results from the investigation of hospital-treated traffic-related pedestrian
injury were presented. This edition deals with fatalities.
Summary
Death data from the ABS Death Unit Record
File (ABS-DURF), held by VISU, were
used for trend analysis. All other analyses
utilised data on traffic-related pedestrian
deaths extracted from the National Coroners
Information System (NCIS). Only closed
cases were selected, 11 pedestrian deaths
were still under investigation at the time of
extraction.
• The number of traffic-related pedestrian
deaths fell significantly by 32% and the
age adjusted death rate fell significantly by
42% in the period 1997-2006. Data for more
recent years are not yet available from the
ABS.
• There were 120 traffic-related pedestrian
deaths recorded on NCIS for the 3-year
period January 2006 to December 2008.
Pedestrian deaths still under investigation
were excluded.
• 57% of pedestrian deaths were male (n=68).
The death rate for males (0.9/100,000) was
higher than that for females (0.7/100,000).
• Just over one-third (34%) of pedestrian
deaths were in age group 75 years and
older. Overall, the death rate was highest in
persons aged 80-84 years (5.6 per 100,000),
followed by persons aged 85+ years (3.4
per 100,000) then persons aged 75-79 years
(3.3 per 100,000). The all-ages pedestrian
fatality rate was 0.8/100,000.
• Residents of 43 of the 79 Victorian Local
Government Areas (LGAs) were killed in
pedestrian crashes. Most pedestrians were
fatally injured in crashes that occurred in the
LGA in which they lived (72%, n=86).
• Saturday was the peak day for pedestrian
deaths (23%).
• Pedestrian road manoeuvre at time of crash:
56% were killed when crossing the road,
mostly at uncontrolled crossings; 9% were
killed on the footpath or median by vehicles
VICTORIAN INJURY SURVEILLANCE UNIT
UNIT
that left the road and crashed into them; 6%
were killed on the footpath, nature strip or
road by reversing vehicles. A further 19%
were killed when lying, standing or walking
on the road or when they jumped/stepped
unexpectedly onto the road (most of these
victims were intoxicated), 2.5% were killed
when attending to broken down vehicles and
2.5% when operating mobility devices.
• 40% of pedestrian fatalities occurred on
urban arterial roads, 26% on rural roads and
23% on highways or freeways.
• Up to three contributory factors were
recorded for each fatality. The major
contributory factors were (in rank order):
pedestrians’ unsafe road use behaviour or
failure to observe/misjudgements of traffic
(implicated in 51 pedestrian deaths); drivers’
unsafe or dangerous behaviour (32 deaths);
pedestrians’ misuse of alcohol and/or licit
or illicit drugs (31 deaths); poor visibility
and/or poor conspicuity of pedestrians (23
deaths); and medical or health condition of
pedestrians (11 deaths).
HAZARD
HAZARD72
72 page
page1 1
• Analysis of coroners’ findings and
information on causality in coroners’
investigation reports indicated that the
pedestrian was primarily responsible for
the fatal crash in 44% of cases, the driver in
25% and there was no finding with regard to
primary responsibility in 32% of cases.
• Sixty percent (n=72) of pedestrian deaths
resulted from multiple injuries, 27% (n=32)
were due to severe head injury.
The high risk groups for pedestrian deaths
are persons aged 75 years and older and
intoxicated males. Readers are referred to
the last issue of Hazard on hospital-treated
pedestrian injury for an extensive discussion
of risk and protective factors and evidencebased prevention measures (http://monash.
edu.au/muarc/VISU/hazard/Haz71.pdf). This
information is summarised in tables in the two
Appendices to this edition.
1. Introduction
The last issue of Hazard (Hazard No 71) was
focused on traffic-related hospital-treated
pedestrian injury. In this issue we report the
results of an in-depth study of traffic-related
pedestrian deaths utilising data extracted from
the National Coroners Information System
(NCIS). We investigated the frequency, trend,
patterns and contributory factors to trafficrelated pedestrian injury deaths in Victoria to
provide information to underpin interventions
to reduce the occurrence of pedestrian crashes
and the severity of crash outcomes.
2. Methods
2.1 Case selection
For the main analyses, cases were selected
from the NCIS.
Only ‘closed’ trafficrelated pedestrian fatalities were selected, 11
additional traffic-related fatalities were found
but excluded as the coronial investigation
was still open. Cases were selected using the
following variables:
1. Case type on completion = death due to
external causes
2. Intent type on completion = unintentional
3. Case jurisdiction = Victoria
4. Mechanism of injury = blunt force >
transport injury event > pedestrian
5. Case year = 2006-2008
3. Results
After initial selection, cases were further
examined then excluded if the cause of death
was recorded as due to:
• suicide;
• a medical condition; or
• a collision with a railway vehicle that
occurred off-road
OR
• if the on-road death of a user of a pedestrian
conveyance such as a wheelchair,
skateboard, inline skates or a toy scooter
was due to a fall or other cause unrelated to
a collision with a motor vehicle or other
form of on-road transport.
3.1 Counts
Over the three-year period 2006-8 there were
120 traffic-related pedestrian deaths recorded
on the NCIS for Victoria (Table 1). Of these
deaths, 50 (42%) occurred in 2006, 30 (25%)
in 2007, and 40 (33%) in 2008. However,
these data may be incomplete as coronial
investigations into 11 further pedestrian
deaths are still open (1 in 2006, 4 in 2007 and
6 in 2008) and there may be other open cases
that were not coded or recorded on the NCIS
at the time of selection.
2.2 Rates and trends
Table 1 shows the counts of traffic-related
pedestrian deaths provided or published by 3
agencies: the NCIS, the Transport Accident
Commission (based on police reports) and the
Australian Bureau of Statistics (ABS). The
difference in counts is explained by different
sources of data and inclusion and exclusion
criteria employed by the three agencies when
classifying cause of death.
Death data from the ABS Death Unit Record
File (ABS-DURF), held by VISU, were used
for trend analysis. Age-adjusted rates were
calculated using the direct method with the
Victorian population at June 30, 2001 as the
standard. Trends were determined using a
log-linear regression model of the rate data
assuming a Poisson distribution of deaths. A
trend was considered statistically significant
if the p-value of the slope of the regression
model was less than 0.05.
Table 1
Frequency of traffic-related pedestrian fatalities by data source,
Victoria 2006-2008
DATA SOURCE
2006
2007
2008
TOTAL
National Coroners
Information System
(NCIS)
50 (51 if all
open cases
included)
30 (34 if all
open cases
included)
40 (46 if all
open cases
included)
120 (131)
Transport Accident
Commission (TAC)
58
41
59
158
Australian Bureau of
Statistics (ABS-DURF)
58
N/A*
N/A*
N/A
Note: ABS-DURF 2007 and 2008 not yet released to VISU due to data and administrative issues at the
ABS end.
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
page 2
3.2 Trend
ABS-DURF data were used to estimate rates
and trends as this is the most complete and
reliable dataset available to VISU for the 10year period 1997-2006. The release of the
Cause of Death Unit Record File for 2007
and 2008 has been delayed by the ABS due to
technical and administrative issues.
Figure 1 Trend in unintentional traffic-related pedestrian injury deaths,
Figure 1 Trend in unintentional
frequency
and rate, Victoria 1997-2006
traffic-related pedestrian injury deaths, frequency and rate, Victoria 1997-2006
According to the ABS-DURF, there were
669 traffic-related pedestrian deaths over the
decade 1997-2006, an average of 67 deaths
per year (range 48 to 89). As shown in Figure
1 both the frequency and rate of traffic-related
pedestrian deaths increased at the very start
of the decade then decreased to 2004 (except
for the sharp increase in 2001) before trending
upward thereafter.
Trend analysis (using Poisson regression
modelling) showed that:
• the frequency of traffic-related pedestrian
deaths decreased significantly over the
decade – the estimated annual decrease
in the number of deaths was 4.1% (95%
confidence interval -7.7% to -0.5%) and
the overall decrease was 34% (-55% to
-5%)
• the death rate also decreased significantly
– the estimated annual decrease in the
death rate was 5.3% (95% confidence
interval -9.1% to -1.7%) and the overall
reduction in the death rate was 42% (-61%
to -16%).
Over the decade male death rates were
consistently higher than those for females.
Death rates for males and females both fell
significantly, by 40% and 44% respectively.
There was a significant 41% fall in the adult
pedestrian death rate over the decade (95%
confidence interval -63% to -11%). The
54% decrease in the child pedestrian death
rate, though large, did not reach statistical
significance (95% confidence interval, -84%
to +14%).
3.3.1 Pedestrian
demographic characteristics
Gender and age
Table 2 shows the frequency and rate of
pedestrian fatalities by age groups and
gender. Victorian population data form the
denominator for rate calculations due to the
lack of a commonly accepted or adopted
measure of pedestrian exposure to risk.
Further analysis of data for persons aged 75
years and older showed that the number of
Overall, 57% of pedestrian fatalities were fatalities was highest in age group 80-84 years
male (n=68) and males were over-represented (n=18, 15% of all pedestrian deaths), followed
in pedestrian deaths in all 15-year age groups by age group 75-79 years (n=14, 12%) and
except in children aged 0-14 years
The age group 85+ (n=9, 8%). The fatality rate
pedestrian fatality rate was higher in males (0.9 was also highest in persons aged 80-84 years
per 100,000 males) than females (0.7/100,000 (5.6 per 100,000), followed by persons aged
85+ years (3.4 per 100,000) then persons aged
per 100,000 females).
75-79 years (3.3 per 100,000). The all-ages
pedestrian fatality rate was 0.8/100,000.
Table 2
Frequency and rate of pedestrian fatalities by age group and gender,
Victoria 2006-2008 (n=120)
AGE
3.3 Characteristics of trafficrelated pedestrian fatalities
The data used in these analyses were derived
from coroners’ findings, police reports and
toxicology reports available on the NCIS.
In both sexes the risk of fatal injury in
pedestrian crashes generally increased as age
increased, with a sharp increase in risk from
age 75 years. In total, 34% of all trafficrelated pedestrian fatalities were in age group
75 years and older. Over the study years,
persons in this age group comprised 6% of
the Victorian population which underscores
the over-representation of older people in
pedestrian fatalities.
GROUP
0-14
MALE
FEMALE
N (%)
Rate/100,000
ALL
N (%)
Rate/100,000
N (%)
Rate/100,000
1 ( 1.5)
0.07
5 ( 9.6)
0.35
6 ( 5.0) 0.20
15-29
10 (14.7)
0.59
7 (13.5)
0.44
17 (14.2)
0.52
30-44
14 (20.6)
0.82
5 ( 9.6)
0.29
19 (15.8)
0.55
45-59
11 (16.2)
0.73
9 (17.3)
0.58
20 (16.7)
0.65
60-74
10 (14.7)
1.10
7 (13.5)
0.73
17 (14.2)
0.91
75 +
22 (32.3)
5.29
19 (36.5)
3.17
41 (34.2)
4.04
68 (100.0)
0.88
52 (100.0)
0.66
120(100.0)
0.77
All ages
Source: National Coroners Information System (NCIS)
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
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Location (LGA) of residence and crash site
Pedestrian fatality data were compared by
Local Government Area (LGA) in which the
fatally injured pedestrian lived (Table 3) and
the LGA where the fatal crash occurred (Table
4).
Over the period 2006-8, residents of 43 of
the 79 Local Government Areas (LGAs) in
Victoria were killed in pedestrian crashes. The
top 12 LGAs for deaths, ranked separately on
frequency and rate, are shown in Table 4. Four
LGAs —Mildura, La Trobe, Maribyrnong and
Stonnington— had both a comparatively high
number and rate of deaths. The high ranking
of Mildura is due to 6 residents being killed
in a single pedestrian crash in 2006 so should
be regarded as a statistical aberration. Nine
of the 12 LGAs that were highly ranked on
the number of their residents killed were in
metropolitan Melbourne, whereas 10 of the 12
LGAs with the highest pedestrian fatality rates
were in rural Victoria.
Cross tabulation of crash location data with
place of residence data showed that most
pedestrians (72%, n=86) were killed in the
LGA in which they lived i.e. relatively close to
home. The 12 highest ranked LGAs for fatal
pedestrian crashes are listed in Table 4 along
with figures that show the number of crashes
that involved their own residents. None of
the fatal pedestrian crashes that occurred in
the City of Melbourne involved their own
residents.
Table 3
RANK
Top 12 Local Government Areas (LGAs) for pedestrian deaths
(among residents) ranked on the frequency and population rate of
pedestrian fatalities in their area, Victoria 2006-8
NUMBER OF RESIDENTS OF LGA KILLED IN PEDESTRIAN CRASHES
RESIDENTS’ PEDESTRIAN
FATALITY RATE
LGA
N
LGA
1
2
3
4
5
6
7
8
9
10
11
12
Casey
Mildura
La Trobe
Greater Dandenong
Monash
Greater Geelong
Maribyrnong
Stonnington
Glen Eira Darebin
Moreland
Brimbank
7
6
6
6
6
6
5
5
4
4
4
4
RATE/100,000
RESIDENTS (N)
Mount Alexander Mildura
Moorabool
Glenelg
Gannawarra
La Trobe South Gippsland
Maribyrnong
Benalla
Wodonga
Horsham
Stonnington
5.6 (3)
3.9 (6)
3.7 (3)
3.2 (2)
2.9 (1)
2.7 (6)
2.5 (2)
2.4 (5)
2.4 (1)
1.9 (2)
1.7 (1)
1.7 (5)
Note: 1Where LGAs had the same number of deaths they were ranked according to population size, with
the LGA with the lowest population given the highest ranking in the group and so forth
Source: National Coroners Information System (NCIS)
Table 4
Top 12 Local Government Areas (LGAs) for fatal pedestrian
crashes, Victoria 2006-8
LGA
NUMBER OF FATAL PEDESTRIAN CRASHES IN
LGA (NUMBER INVOLVING OWN RESIDENTS)
1
Monash
7(5)
2
Mildura
6(6)
3
La Trobe
6(6)
4
Greater Dandenong
6(5)
5
Greater Geelong
6(6)
6
Casey
6(4)
7
Maribyrnong
5(3)
8
Stonnington
5(3)
9
Yarra 4(3)
10
Glen Eira 4(2)
11
Kingston
4(2)
12
Melbourne2
4(0)
Notes:
Source:
VICTORIAN INJURY SURVEILLANCE UNIT
Where LGAs had the same number of fatal crashes they were ranked according to population size,
with the LGA with the lowest population given the highest ranking in the group and so forth
2
City of Melbourne has a lower resident population than Kingston and Glen Eira but is ranked
12th because of the estimated 771,000 people who use the city each day.
National Coroners Information System (NCIS)
1
HAZARD 72
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3.3.2 Time of occurrence of
crash
Season of year
Figure 2
Season in which the pedestrian-related fatalities occurred by age
group, Victoria 2006-2008
Fatal pedestrian crashes were fairly evenly
distributed across autumn (n=34, 28%), winter
(n=32, 27%) and summer (n=30, 25%), with
the lowest number occurring in spring (n=24,
20%). Figure 2 shows the seasonal pattern by
age group. Among persons aged 30-44 and 75
years and older, winter was the most common
season in which fatalities occurred whereas
autumn was more common in fatalities among
0-14 and 45-59 year olds. Among 15-29 year
olds, there was a high proportion of deaths in
summer but this was due to a multiple fatality.
Day of week
Figure 3 shows the distribution of pedestrian
fatalities by day of week. Twenty-three
percent of all pedestrian-related deaths
occurred on a Saturday (n=28), the peak day
for deaths, compared with 9% (n=11) on a
Sunday. There was a fairly even spread of
pedestrian fatalities across week days (1316%), except for Wednesday (10%).
Figure 3 Distribution of pedestrian deaths by day of week, Victoria 2006-2008
Day of week by gender
The commonest day for fatal pedestrian
crashes involving males was Saturday (n=19,
28%) whereas it was Thursday for females (n=
13, 25%).
Time of day
The Geoscience Australia website was used to
determine whether the fatal crashes occurred
during daytime, night time, dawn or dusk
(Figure 4). Forty-nine percent (n=59) of fatal
pedestrian crashes occurred during daytime,
39% (n=47) occurred at night and 4% (n=5)
occurred at dawn or dusk. The time of day for
9 deaths (8%) was not recorded on the NCIS.
Figure 4
Distribution of pedestrian deaths by time of day, Victoria 2006-2008
Time of day by age
More than two-thirds of children aged 0-14
(n=4, 67%) and adults aged 60 years and
older (n=40, 69%) were killed in daytime.
In contrast, persons aged between 15 and 44
were much more likely to be killed at night
than during the day (72% versus 17%). In the
15-19 age group, 90% (n=9) of male fatalities
occurred at night as did 71% (n=5) of female
fatalities. Persons aged 45-59 were equally
likely to be killed in daytime as night-time.
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
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3.3.3 Type of vehicle
involved in collision
Figure 5 Vehicles involved in fatal pedestrian crashes, Victoria 2006-2008
As shown in Figure 5, most pedestrian deaths
occurred in crashes with passenger cars (n=85,
71%), followed by light trucks, vans or utility
vehicles (n=15, 13%) and trucks (n=11, 9%).
3.3.4 Nature of crash
Pedestrian road manoeuvre and crash
circumstances
Information on the road manoeuvre being
performed by the pedestrian at the time of the
fatal crash is summarised in Table 5.
Crossing road
Fifty-six percent of all pedestrian fatalities
(n=67) occurred when the pedestrian was
crossing the road. These were mostly at
uncontrolled crossings either from the kerb/
median strip (n=44, 37% of all pedestrian
fatalities) or through parked or stationary
vehicles (n=7, 6%). Thirteen percent of all
fatal crashes (n=16) occurred on controlled
crossings.
Crossing road at uncontrolled crossings
Fifteen pedestrians were struck on the far
side of the road at uncontrolled crossings.
They mostly had traversed several lanes and
then misjudged the distance of an oncoming
vehicle and walked or ran into its path. Only
one was reported to be under the influence of
drugs or alcohol. All but two were aged 65
years or older (87%).
Of the 15 pedestrians involved in near-side
fatal collisions at uncontrolled crossings,
nine suffered fatal injuries when they stepped
out from the kerb or median strip in front of
vehicles. Another two occurred when the
pedestrian changed his or her mind, hesitated,
stopped or double backed into the path of a
vehicle. Three of the remaining four cases
happened when the pedestrian suddenly ran
onto the road, two of whom were children.
Only two of the near-side crash victims had
high BAC levels.
In total, eight of the fifteen pedestrians
(53%) involved in fatal near side collisions at
uncontrolled crossings were aged 70 years or
older. At least four of these older pedestrians
suffered from dementia and/or vision and
hearing problems and two others appeared
unaware of approaching vehicles.
There was no information on the side of the
road on which the pedestrian was hit for 12
cases that occurred at uncontrolled crossings.
Source: NCIS (2006-2008)
Three were rushing across the road, two to
catch public transport. Two pedestrians were
highly intoxicated and in a further case the
pedestrian and the vehicle driver had BAC
levels of 0.11 and 0.09, respectively. A variety
of factors contributed to the other deaths:
visibility issues (vegetation obscuring vision
of pedestrian and driver and bad weather); the
pedestrian was vision impaired; and pedestrian
misjudgement. Two other pedestrians were
hit during uncontrolled crossings when they
unexpectedly turned back into the path of
vehicles.
A further seven fatalities at uncontrolled
crossings happened when the pedestrian
emerged through parked or stationary vehicles
into the path of moving vehicles.
Crossing road at controlled crossings
Of the 16 fatalities (13% of all pedestrian
fatalities) that happened on controlled
crossings, seven occurred when the pedestrian
was crossing illegally against a red light and
one other when the pedestrian was using a
non-operational children’s crossing.
Of the six fatalities that occurred when the
pedestrian was crossing with the green light,
three people were killed by speeding vehicles
that were driven/ridden through the red light,
one by a vehicle turning right onto a highway
when the driver failed to see the pedestrian
on the crossing, and two when the driver was
distracted at the time of the crash.
Two other deaths occurred on controlled
crossings with no information given on the
light cycle and sparse information on the
circumstances.
VICTORIAN INJURY SURVEILLANCE UNIT
Pedestrian hit by reversing vehicles
Seven pedestrians (6% of fatalities), including
one person riding a mobility scooter, were
killed by reversing vehicles, five by vehicles
backing out of driveways and two by vehicles
backing on the roadway.
Pedestrian on footpath, kerb, traffic
island or verge hit by vehicle
Eleven pedestrians (9% of fatalities) were
killed by vehicles that left the road and crashed
into them either when they were walking
on a footpath or the verge of a roadway (not
on the road), standing on a kerb or traffic
island, or sitting on outdoor seating of a cafe.
Dangerous/erratic driving (due to speeding)
and driver error caused most of these crashes.
Pedestrian hit when lying, standing,
walking or stepping/jumping on road
Twenty-three deaths (19% of all pedestrian
fatalities) occurred when the victim was lying,
standing, walking on the road or jumped/
stepped unexpectedly onto the road.
Nine of the 10 pedestrians killed when
lying or standing on the road were highly
intoxicated, five by alcohol alone and four
by a combination of alcohol and other drugs.
Eleven pedestrians were walking on the road
when killed, most commonly on rural roads.
Seven of these were under the influence of
alcohol or a combination of alcohol and drugs
and in two further cases the driver was highly
intoxicated and lost control of the vehicle.
Other contributory factors mentioned in
reports on these crashes included mental
illness/impairment, wearing dark clothing
when walking on poorly lit roads, walking
with back to traffic and lack of care when
walking in a group (stepping out onto road).
HAZARD 72
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Person attending to broken down
vehicles
Three people (2.5% of fatalities) were killed
when attending to broken down vehicles on
the road either by being crushed or run over.
Mobility device users
Three fatalities involved persons using
mobility devices (2.5% of fatalities), two
when driving mobility scooters unsafely.
Pedestrian’s point of fatal impact with
vehicle
Frontal impact collisions were most common
(n=90, 75%). There were no further details
of point/s of impact in 82% of these cases,
but in 18% (n=16) it was reported that the
pedestrian impacted with the windscreen. In
11% of cases (n=13) the point of impact was
the wheel or undercarriage, and in 8% of cases
(n=10) the pedestrian was struck by the rear
end of the vehicle.
3.3.5 Crash environment
Type of road
Forty percent (n=48) of pedestrian fatalities
occurred on urban arterial roads, 26% (n=31)
on rural roads and 23% (n=27) on highways
or freeways.
Fifty-nine percent (n=16)
of pedestrian fatalities that occurred on
highways/freeways were on urban highways/
freeways.
Proximity to an intersection
Fifty-seven percent (n=68) of pedestrian
fatalities occurred mid-block (i.e. between
intersections), while 13% (n=16) occurred
at intersections and 6% (n=7) occurred
on driveways (outside the fence line of a
residence) or laneways.
Weather conditions
Weather conditions at the time of the crash
were inconsistently reported on the NCIS
with no information given for 65% (n=78) of
cases. In the one-third of fatalities (n=42) for
which information was available, 74% (n=31)
occurred in fine weather compared with 26%
(n=11) in rain, fog or other adverse conditions.
Light level
Fifty-nine pedestrian fatalities (49%) occurred
in daytime. There was no information on
lighting in 30 of the 61 fatalities (51%) that
occurred at night, dawn or dusk. Of the
remainder, 13 (11% of all fatalities) occurred
on roads where there was no street lighting,
13 (11%) occurred on roads with poor street
lighting and 5 (4%) occurred on roads with
good street lighting.
Table 5
Pedestrian road manoeuvre at the time of the crash
ROAD MANOEUVRE
N
1. Pedestrian crossing road •
At uncontrolled crossing from kerb/median %
67 55.8
44
36.7
7
5.8
16
13.3
– pedestrian hit by vehicle on far side of road from kerb/median (15)
– pedestrian hit by vehicle on near side of road from kerb/median (15)
– pedestrian hit by vehicle, no information on side (12)
– pedestrian hit by vehicle when unexpectedly turned back into path of vehicle (2) •
At uncontrolled crossing through parked or stationary vehicles or after alighting from vehicle
– collision on near side of road after a person emerged from in front of or
behind vehicle at the kerb or on far side when person emerged into lane
of moving traffic from between stationary traffic (4)
– after alighting from vehicle (2)
– other (1) •
At controlled crossing from kerb/median
– ran/walked across road against red pedestrian light (7)
– crossing with green pedestrian light when hit by vehicle (6)
– other/no information on light cycle (3)
2. Pedestrian hit by reversing vehicle
7
•
Collision involving vehicle reversing out of driveway
5
4.2
•
Collision involving vehicle reversing on road
2 1.7
3. Pedestrian on footpath/verge hit by vehicle when vehicle left road
11
•
Person on footpath or pedestrian island when vehicle left road and crashed into person
5
4.2
•
Person walking on verge of road (no footpath) when vehicle left road and crashed into person 6
5.0
4. Collision involving person walking, lying or standing on road or jumping onto road when hit by vehicle
5.8
9.2
23 19.2
•
Person walking on the road when hit by vehicle
11
9.2
•
Person standing on road when hit by vehicle 5
4.2
•
Person walking on road when hit by vehicle 5
4.2
•
Person stepped/jumped onto road in front of vehicle 2
1.7
5. Prior vehicle occupant or mechanic struck when attending vehicle at roadside (or run over by vehicle being attended)
3
2.5
6. Person using mobility device/walking aid struck by vehicle
3
2.5
6
5.0
•
Person on mobility scooter driving unsafely (2)
•
other (1)
7. Other
TOTAL
VICTORIAN INJURY SURVEILLANCE UNIT
120
HAZARD 72
100
page 7
3.3.6 Contributory factors:
top 5 in detail
This information was primarily drawn from
the Coroner’s Record of the Investigation into
the Death. Police reports were consulted in
a small number of cases where the Coroners’
Records lacked information. No contributory
factors were recorded in nine cases. Up to
three factors were recorded per case in the
other 111 cases. In total 152 contributory
factors were recorded (mean: 1.4; range 1-3
factors).
The contributory factors to pedestrian
fatalities were (in rank order): pedestrians’
unsafe road use behaviour or failure to
observe/misjudgements of traffic (implicated
in 51 pedestrian deaths); drivers’ unsafe or
dangerous behaviour (32 deaths); pedestrians’
use of alcohol and/or drugs (31 deaths); poor
visibility/poor conspicuity of pedestrians
(23 deaths); medical or health condition
of pedestrians (11 deaths); drivers’ use of
alcohol – BAC reading above 0.05gm/100ml
(5 deaths); driver distraction (4 deaths);
lack of awareness by driver and pedestrian
(3 deaths); lack of parental supervision of
child pedestrians (3 deaths); vehicle faults
(3 deaths: faulty handbrake, bald tyres, fuel
contamination); and drivers’ health or medical
condition (2 deaths).
Major factor 1 - Pedestrians’ unsafe
road use behaviour (implicated in 51
deaths)
The behaviour of pedestrians at the time
of the crash is analysed in detail in 3.3.4.
Unsafe pedestrian behaviours mainly involved
misjudgements of speed and/or distance of
oncoming vehicles and failure to look or
observe on-coming vehicles when crossing
the road. Reckless road crossing behaviours
included crossing either between stationary
or parked vehicles without keeping a proper
lookout and running across the road including
arterial roads and multi-lane highways.
Major factor 2 - Drivers’ unsafe or
dangerous behaviour including driver
distraction and lack of awareness
(implicated in 32 deaths)
Driving at excess speed (above speed limit or
too fast for safe performance of driving task)
was the major driver-related contributory
factor to pedestrian deaths (implicated in
11 deaths), followed by lack of general
awareness/failure to keep proper lookout
especially when reversing (9 deaths); driver
distraction e.g., eating, operating vehicle radio
controls, texting (6 deaths); and failure to obey
traffic signals (4 deaths). Driving operational
errors caused three crashes and loss of control
of vehicle (no other details) another two.
Unlicensed driving only contributed to one
death.
Drivers’ use of alcohol
In addition, drivers’ use of alcohol was a factor
in 5 deaths; 4 of the 5 drivers having a BAC of
0.05gm/100ml and higher.
Major factor 3 - Pedestrians’ alcohol
and other drug misuse (implicated in
31 deaths)
Alcohol
Toxicology findings were available for 99 of
the 120 pedestrian fatalities. Twenty-seven
pedestrians (27% of fatal cases with toxicology
findings) had BAC readings of 0.05 gm/100ml
or greater. Most of these pedestrians (74%,
n=20) had readings of 0.15 gm/100ml and
above.
Figure 6
Figure 6 shows BAC level by gender.
Overall, 22 males (37% of the 60 males with
toxicology reports) had a BAC level of 0.05
gm/100ml or greater, 73% (n=16) of whom
had a BAC of 0.15 gm/100ml or greater. By
contrast, only 13% (n=5) of the 39 females
with toxicology reports available had a BAC
level of 0.05gm/100ml and above, but four of
these cases (80%) had BAC readings of 0.15
gm/100ml and above.
Of the 27 pedestrian fatalities with BAC
readings of 0.05 gm/100ml or greater, 41%
(n=11) were aged 30-44 years, 30% (n=8)
were aged 15-29, 19% (n=5) were aged 4559, 7% (n=2) were aged 75 years and older
and 4% (n=1) was aged 60-74 years. Usage
rate at 0.05gm/100mg and above was lowest in
the oldest age group with alcohol use detected
at this level in only two of the 41 deceased
pedestrians aged 75 years or older (5%).
Of the 20 cases with a BAC reading of 0.15
gm/100ml or greater, 50% (n=10) were aged
30-44 years, 30% (n=6) were aged 15-29,
15% (n=3) were aged 45-59 and 5% (n=1)
was aged 60-74 years. The coroners’ reports
provided information on where 12 of these
highly intoxicated pedestrians had been
drinking prior to the crash. Five were killed
after drinking at pubs and/or clubs, four at
celebrations (weddings and parties) in public
halls/reception places and three after social
drinking in other settings.
Blood Alcohol Concentration (BAC) among pedestrian fatalities,
Victoria 2006-2008
A small number of deaths (7) were due to
illegal road crossing when the pedestrian
crossed against the red pedestrian signal or
disobeyed traffic signals at an intersection.
In a few cases pedestrians ignored controlled
crossings nearby and made uncontrolled
crossings.
Pedestrians hit when lying, standing or
walking on the road were mostly under the
influence of alcohol and/or other drugs or, in
two cases, suffering from a mental illness/
impairment.
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
page 8
Other drugs
‘Other’ drugs (licit and illicit) were detected in
14% (n=14) of the 99 fatalities with toxicology
reports available, however in one case a single
licit drug was detected at a level consistent
with therapeutic use so was omitted from the
analysis. In the 13 remaining cases, ‘other’
drugs were taken in combination or with
alcohol. Cannabis was present in 5% (n=5)
of deceased pedestrians; all these pedestrians
had BAC readings of 0.05 gm/100ml or above.
Other illicit drugs such as methamphetamine
(speed), methylenedioxymethamphetamine
(ecstasy) and methylenedioxyamphetamine
(MDA) were present in 3% (n=3) of deceased
pedestrians; BAC readings in these pedestrians
were all 0.05 gm/100ml and above. Licit
drugs (including caffeine, sertraline and
diltiazem) used alone or in combination above
the therapeutic range were present in 6%
(n=6) of deceased pedestrians.
Major factor 4 - Poor visibility and/or
conspicuity of pedestrian (implicated
in 23 deaths)
The factors found to have adversely affected
the visibility of pedestrians to drivers, often
operating in tandem, were: lack of natural light
(9 deaths), inclement weather - rain or fog (10
deaths), no or dim street lighting (7 deaths)
and obstructions to the sightline between
driver and pedestrian, for example trees and
shrubs (2 deaths). In 10 of these cases, the
dark clothing being worn by the pedestrian
was cited as a secondary contributory factor.
In one further death the driver was dazzled by
headlights from an oncoming vehicle.
Major factor 5 - Medical or health
condition of pedestrian (implicated
in 11 deaths)
The medical and health conditions suffered
by pedestrians that contributed to their
involvement in fatal pedestrian crashes
included: hearing and/or sight impairments,
mental illness/condition, restricted mobility,
hypertension and a ‘medical complaint’, not
further specified. Given that around one-third
of fatally injured pedestrians were aged 75
years and older it is likely that medical or
health conditions are under-reported.
3.3.7 Overall responsibility
for crash
Analysis of coroners’ findings, and when a
formal finding of responsibility was not made,
information in the coroners’ investigation
report, indicated that the pedestrian was
primarily responsible for the fatal crash in
44% of cases, the driver in 25%, both driver
Figure 7
Body region injured: traffic-related pedestrian fatalities,
Victoria 2006-2008
Source: NCIS (2006-2008)
and pedestrian were held equally responsible
in one case (0.8%) and another, involving a
crane under repair on a roadway, was due to
safety systems failure (0.8%). There was no
finding with regard to primary responsibility
in 32% of cases as causes were either
multifactorial or, less commonly, there was a
lack of information. In two cases the coroners
report was incomplete, but information in
the attached police report indicated that the
pedestrian bore primary responsibility in one
case and the driver in the other.
3.3.8 Nature of injuries to
pedestrians
Sixty percent (n=72) of pedestrian deaths
resulted from multiple injuries, 27% (n=32)
were due to severe head injury, and 3% (n=4)
to severe head and chest injury. Three percent
(n=3) of pedestrians died from the secondary
effects of their injuries. (Figure 7).
3.3.9 Place of occurrence of
death
Over half of pedestrian deaths (n=64, 53%)
occurred in hospital, 41% (n=49) occurred
before hospitalisation (i.e. at the scene of
the crash), and 3% (n=4) occurred during
assistance by medical/ambulance officers or in
transit to hospital.
4. Discussion
An extensive discussion of the pattern of
pedestrian injury, risk and protective factors
VICTORIAN INJURY SURVEILLANCE UNIT
and evidenced-based pedestrian injury
countermeasures was included in the last
issue of Hazard. The discussion covered both
fatalities and hospital-treated injury so only a
few additional points will be made here.
Similar to the pattern for pedestrian
hospitalisations, the number and rate
of pedestrian fatalities have declined
significantly since the late 1990s, with much
of the decrease occurring between 2002 and
2004, attributed to the reduction in default
speed limit in 2001 and the strengthened
approach to speed enforcement from early
2002. As for hospitalisations, the benefits of
these interventions have been absorbed and
an increase, then levelling off, of fatalities is
evident in 2005 and 2006.
As reported in the previous Hazard, trafficrelated
pedestrian
hospitalisations
in
2006-8 peaked in young people aged
15-29 years, although the hospital admissions
rate was highest in persons aged 75 years
and older followed by persons aged 15-29.
By comparison, the current study shows
that over the same 3-year period more than
one-third of pedestrian fatalities occurred
in persons aged 75 years and older with the
remaining two-thirds (less six child deaths)
fairly evenly spread across adult age groups
to age 74 years. Fatality rates increased with
age, sharply climbing from age 75 years. The
difference in age pattern between hospital
admissions and deaths is most likely due to the
greater physical vulnerability of older people
(including underlying health conditions) that
renders them more likely to die of comparable
injury than their younger counterparts (Martin
et al., 2008).
HAZARD 72
page 9
In the previous issue of Hazard we reported
that alcohol use was a contributory factor to
12% of pedestrian hospitalisations in Victoria
that occurred in 2006-8. We also noted that
a recent Australian research study indicates
that this figure is a gross underestimate due
to poor recording at the hospital level of
known alcohol involvement in transport injury
hospitalisations (McKenzie et al., 2010). In
the current study, toxicology reports were
available for 83% of pedestrian fatalities
recorded on the NCIS and alcohol use was
detected in around one-third of pedestrians
with toxicology reports. Twenty-seven percent
of deceased pedestrians for whom information
on alcohol involvement was available had
blood alcohol readings of 0.05gm/100ml or
greater, three-quarters of whom were highly
intoxicated with readings of 0.15gm/100ml
and above.
We found that alcohol involvement was low
in females and those aged 75 years and older.
Twenty of the 27 deceased pedestrian with
BAC readings at or above 0.05 were in age
group 15-44 years (18 males and two females)
and 16 of the 20 who were highly intoxicated
(BAC 0.15 and above) were also in this age
group (14 males and 2 females). The high
involvement of alcohol in male pedestrian
deaths was previously reported in an earlier
coronial study covering pedestrian deaths that
occurred in Australia over the period 19982002 (ASTB, 2003).
The current study indicates that priority
populations for prevention are older adults and
heavy/binge drinkers especially young males.
Readers are referred to the last issue of Hazard
on hospital-treated pedestrian injury for an
extensive discussion of the risk and protective
factors for pedestrian injury and evidencebased prevention measures (http://monash.
edu.au/muarc/VISU/hazard/Haz71.pdf). This
information is summarised in a table appended
to this report - see Table A in Appendix 1. A
list of the recommended pedestrian safety
countermeasures relevant to the safety issues
identified by our analysis of Victorian deaths
and hospital-treated injury data can be found
in Table B, Appendix 2.
References
Abdel-Aty M, Keller J. Exploring the
overall and specific crash severity levels at
signalized intersections. Accid Anal Prev.
2005; 37(3): 417-425.
Al-Ghamdi AS. Pedestrian-vehicle crashes
and analytical techniques for stratified
contingency tables. Accid Anal Prev. 2002;
34(2): 205-214.
Anderson RW, McLean AJ, Farmer MJ, Lee
BH, Brooks CG.Vehicle travel speeds and
the incidence of fatal pedestrian crashes.
Accid Anal Prev. 1997; 29(5): 667-674.
Australian Bureau of Statistics. 9309.0 –
Motor Vehicle Cencus, Australia, 31 Mar
2009.
Australian Transport Safety Bureau. Road
fatalites among older pedestrians. ATSB
Monograph 13, Canberra 2002 http:/
www.infrastructure.gov.au/roads/safety/
publications/2002/Ped_Age_2.aspx.
Dowloaded 14/04/2010.
Australian
Transport
Safety
Bureau.
Male
pedestrian
fatalities.
ATSB
Monograph
14,
Canberra
2003.
http:/www.infrastructure.gov.au/roads/
safety/publications/2003/Ped_Male_1.
aspx. Dowloaded 14/04/2010.
Austroads. Pedestrian and cycling safety –
pedestrian crashes at pedestrian facilities.
Report No. AP-R156, Austroads, Sydney,
2000.
Bartley Consulting Pty Ltd. Walking and
cycling census analysis. Consultancy report
prepared for the Victorian Department of
Transport, Walking and Cycling Branch.
September 2008.
Beck LF, Paulozzi LJ, Davidson SC.
Pedestrian fatalities, Atlanta Metropolitan
Statistical Area and United States, 20002004. J Safety Res. 2007; 38(6): 613-616.
Bradbury A. Pattern and severity of injury
sustained by pedestrians in road traffic
accidents with particular reference to the
effect of alcohol. Injury.1991; 22(2): 132134.
Bungum TJ, Day C, Henry LJ. The association
of distraction and caution displayed by
pedestrians at a lighted crosswalk. J.
Community Health. 2005; 30(4): 269-79.
Bunn F, Frost C, Ker K, et al. Area-wide
traffic calming for preventing traffic related
injuries. Cochrane Database of Systematic
Reviews 2003, Issue 1. Art. No.: CD003110.
Cairney P, Stephenson W, Macaulay J.
Preventing crashes involving intoxicated
pedestrians. Stage 2 – An analysis of
Australian coronial records, 1999-2001. In:
Austroads Research Report AP-R260/04
pp. 63-119. Sydney: Austroads.
VICTORIAN INJURY SURVEILLANCE UNIT
Chalabi Z, Roberts I, Edwards P, et al.Traffic
and the risk of vehicle-related pedestrian
injury: a decision analytic support tool. Inj
Prev. 2008; 14(3): 196-201.
Chang L, Wang H. Analysis of traffic injury
severity: An application of non-parametric
classification tree techniques. Accid Anal
Prev. 2006; 38(5): 1019-1027.
Charlton J, Oxley J, Scully J, et al. Selfregulatory driving practices of older drivers
in the ACT and NSW. Monash University
Accident Research Centre; October 2006.
Report No.: 254. www.monash.edu.au/
muarc/reports/muarc254.pdf
Chisholm SL, Caird JK, Lockhart J. The
effects of practice with MP3 players on
driving performance. Accid Anal Prev.
2008; 40(2): 704-713.
Clapperton A, Cassell E. The impact of area
socioeconomic inequity on serious injury
in Victoria. Hazard Edition No 70 Summer
2009/10. Victorian Injury Surveillance
Unit. Melbourne.
Clifton K, Burnier C, Akar G. Severity of
injury resulting from pedestrian-vehicle
crashes: What can we learn from examining
the built environment? Transp. Res.: Part D:
Transport Environ. 2009; 14(6): 425-436.
Connelly ML, Conaglen HM, Parsonson
BS, et al. Child pedestrian’s crossing gap
thresholds. Accid Anal Prev. 1998; 30(4):
443-453.
Connelly LB, Supangan R. The economic
costs of road traffic crashes: Australia,
states and territories. Accid Anal Prev.
2006; 38(6): 1087-1093.
Corben B, D’Elia A, Healy DJ. Estimating
pedestrian fatal crash risk. In: Proceedings,
2006 Australasian Road Safety Research,
Policing and Education Conference.
October 2006, Gold Coast, Australia.
Corben B.F. Achieving safe traffic
environments for pedestrians. Melbourne,
Victoria: Monash University, 2007. Thesis.
Corben BF, Diamantopoulou K, Mullan N,
Mainka B. Environmental countermeasures
for alcohol-related pedestrian crashes.
Monash University Accident Research
Centre; 1996, Report No. 101.
Delaney A, Newstead S, Corben B. Outcome
evaluation of the effectiveness of the Safe
Routes to Schools program. Monash
University Accident Research Centre; 2004,
Report No. 225.
Delaney A, Diamantopoulou K, Cameron
M. Strategic principles of drink-driving
enforcement. Monash University Accident
Research Centre; July 2006. Report No.:
249. www.monash.edu.au/muarc/reports/
muarc249.pdf
HAZARD 72
page 10
Demetriades D, Murray J, Martin M, et
al. Pedestrians injured by automobiles:
relationship of age to injury type and
severity. J Am Coll Surg. 2004; 199(3):
382-387.
Desapriya E, Subzwari S, Sasges D, et al. Do
light truck vehicles (LTV) impose greater
risk of pedestrian injury than passenger
cars? A meta-analysis and systematic
review. Traffic Inj Prev. 2010; 11(1): 48-56.
Dobson A, Smith N, McFadden M, et al. In
Australia are people born in other countries
at higher risk of road trauma than locally
born people? Accid Anal Prev. 2004; 36(3):
375-381.
Drews FA, Yazdani H, Godfrey CN et al. Text
messaging during simulated driving. Hum
Factors. 2009; 51(5): 762-70
Duperrex OJM, Roberts IG, BunnF. Safety
education of pedestrians for injury
prevention.
Cochrane
Database
of
Systematic Reviews 2002, Issue 2. Art. No.:
CD001531.
Durkin MS, Davidson LL, Kuhn L, O’Connor
P, Barlow B. Low-income neighborhoods
and the risk of severe pediatric injury: a
small-area analysis in Northern Manhattan.
Am J Public Health. 1994; 84(4): 587-592.
Eluru N, Bhat CR, Hensher DA. A mixed
generalized ordered response model for
examining pedestrian and bicyclist injury
severity level in traffic crashes. Accid Anal
Prev. 2008; 40(3): 1033-1054.
Federal Office of Road Safety (FORS).
Pedestrian fatalities in Australia. Monograph
7, Federal Office of Road Safety, Canberra,
Australia, 1996. http://www.rsconference.
com/pdf/RS07037.pdf?check=1
Fontaine H, Gourlet Y. Fatal pedestrian
accidents in France: A typological analysis.
Accid Anal Prev. 1997; 29(3): 303-312.
Gårder PE. The impact of speed and other
variables on pedestrian safety in Maine.
Accid Anal Prev. 2004; 36(4): 533-542.
Giles-Corti B, Kelty SF, Zubrick et al.
Encouraging walking for transport and
physical activity in children and adolescents:
how important is the built environment?
Sports Med. 2009; 39(12): 995-1009.
Graham DJ, Stephens DA. Decomposing the
impact of deprivation on child pedestrian
casualties in England. Accid Anal Prev.
2008; 40(4): 1351-1364.
Harkey D, Zegeer C. PEDSAFE: Pedestrian
safety guide and countermeasure selection
system. Washington D.C., FHWA 2004.
Harrison JE & Berry JG. Injury of Aboriginal
and Torres Strait Islander people due to
transport, 2001–02 to 2005–06. Injury
research and statistics series number 46.
Cat. no. INJCAT 120. Adelaide: AIHW,
2008
Harruff RC, Avery A, Alter-Pandya AS.
Analysis of circumstances and injuries in
217 pedestrian traffic fatalities. Accid Anal
Prev. 1998; 30(1): 11-20.
Hatfield J, Murphy S. The effects of mobile
phone use on pedestrian crossing behaviour
at signalized and unsignalized intersections.
Accid Anal Prev. 2007;39(1):197-205.
Hatfield J, Fernandes R, Soames Job RF,
Smith K. Misunderstanding of right-of-way
rules at various pedestrian crossing types:
observational study and survey. Accid Anal
Prev. 2007; 39(4): 833-42.
Haworth N, Johnson IR, Vulcan AP. Mid-term
review of arrive alive!, Victoria’s road safety
strategy 2002-2007, Part 2: Comparison of
actual and predicted road trauma reduction
of each initiative, Monash University
Accident Research Centre, contract report
prepared for VicRoads, Victoria, Australia,
2005.
Hedelin A, Björnstig U, Brismar B. Trams--a
risk factor for pedestrians. Accid Anal Prev.
1996; 28(6): 733-738.
Hewson P. Deprived children or deprived
neighbourhoods? A public health approach
to the investigation of links between
deprivation and injury risk with specific
reference to road safety in Devn County,
UK. BMC Public Health. 2004; May
10;4:15
Hippisley-Cox J, Groom L, Kendrick D,
Coupland C, Webber E, Savelyich B.
Cross sectional survey of socioeconomic
variations in severity and mechanism of
childhood injuries in Trent 1992-7. BMJ.
2002; 324(7346): 1132.
Holubowycz OT. Age, sex, and blood
alcohol concentration of killed and injured
pedestrians. Accid Anal Prev. 1995; 27(3):
417-422.
Hoareau E, Newstead S, Cameron M. An
evaluation of the default 50 km/h speed limit
in Victoria. Melbourne: Monash University
Accident Research Centre; November
2006. Report No.: 261. www.monash.edu.
au/muarc/reports/muarc261.pdf
Hosking SG, Young KL, Regan MA. The
effects of text messaging on young drivers.
Hum Factors. 2009;51(4):582-92.
Hotz G, Kennedy A, Lufti K et al. Preventing
pediatric pedestrian injuries. J Trauma.
2009;66:1492-1499.
Hutchinson TP, Kloeden CN, Lindsay
VL. Countermeasures to the problem of
accidents to intoxicated pedestrians. J
Forensic Leg Med. 2010; 17(3):115-9.
Kim JK, Ulfarsson GF, Shankar VN, et al. Age
and pedestrian injury severity in motorvehicle crashes: A heteroskedastic logit
analysis. Accid Anal Prev. 2008; 40(5):
1695-1702.
VICTORIAN INJURY SURVEILLANCE UNIT
King MJ, Soole D, Ghafourian A. Illegal
pedestrian
crossing
at
signalised
intersections: incidence and relative risk.
Accid Anal Prev. 2009;41(3):485-90.
Kwan I, Mapstone J. Interventions for
increasing pedestrian and cyclist visibility
for the prevention of death and injuries.
Cochrane Database of Systematic Reviews
2006, Issue 4. Art. No.: CD003438.
LaScala EA, Gerber D, Gruenewald PJ.
Demographic and environmental correlates
of pedestrian injury collisions: a spatial
analysis. Accid Anal Prev. 2000; 32(5):
651-658.
Lee C, Abdel-Aty M. Comprehensive
analysis of vehicle-pedestrian crashes at
intersections in Florida. Accid Anal Prev.
2005; 37(4): 775-786.
Loo BP, Tsui KL. Pedestrian injuries in an
ageing society: insights from hospital
trauma registry. J Trauma. 2009; 66(4):
1196-201.
Lorenc T, Brunton G, Oliver S et al. Attitudes
to walking and cycling among children,
young people and parents: a systematic
review. J. Epidemiol Community Health
2008; 62: 852-857.
Lyons RA, Jones SJ, Deacon T, Heaven
M. Socioeconomic variation in injury in
children and older people: a population
based study. Inj Prev. 2003; 9: 33-37.
Mabunda MM, Swart LA, Seedat M.
Magnitude and categories of pedestrian
fatalities in South Africa. Accid Anal Prev.
2008; 40(2): 586-593.
Martin A. Factors influencing fatality and
injury severity risk in pedestrian crashes.
Report PPR241 Transport Research
Laboratory, prepared for TFL, London
Road Safety Unit 2006.
Martin AJ, Hand EB, Trace F, O’Neill
D. Pedestrian fatalities and injuries
involving Irish older people. Gerontology
2010;56:266-271.
McCartt AT, Hellinga LA, Bratiman KA. Cell
phones and driving: review of research.
Traffic Inj Prev. 2006; 7(2): 89-106.
McEvoy SP, Stevenson MR, McCartt AT, et
al. Role of phones in motor vehicle crashes
resulting in hospital attendance: a casecrossover study. BMJ. 2005; 331(7514):
428.
McKenzie K, Harrison JE, McClure RJ.
Identification of alcohol involvement in
injury-related hospitalisations using routine
data compared to medical record review.
Aust NZ J Public Health 2010;34:146-152.
Nasar J, Hecht P, Wener R. Mobile telephones,
distracted attention, and pedestrian safety.
Accid Anal Prev. 2008;40(1):69-75.
HAZARD 72
page 11
Olson, R.L., Hanowski, R.J., Hickman, J.S.,
& Bocanegra, J. Driver Distraction in
Commercial Vehicle Operations. FMCSA
RRR 09 042. Washington, DC: Federal
Motor Carrier Safety Administration. 2009,
September.
Öström M; Eriksson A. Pedestrian fatalities
and alcohol. Accid Anal Prev. 2001; 33(2):
173-180.
Oxley J, Fildes B, Ihsen E et al. Differences
in traffic judgments between young and old
adult pedestrians. Accid anal Prev. 1997;
29(6): 962-971
Oxley JA, Ihsen E, Fildes BN et al. Crossing
roads safely: an experimental study of age
differences in gap selection by pedestrians.
Accid Anal Prev. 2005 Sep; 37(5):962-71.
Oxley J, Lenne M, Corben B. The effect
of alcohol impairment on road crossing
behaviour. Transportation Research Part F:
Traffic Psychology and Behaviour 2006;
9(4): 258-268.
Oxley JA, Congiu M, Whelan M, D’Elia
A, Charlton J. The impacts of functional
performance, behaviour and traffic exposure
on road-crossing judgements of young
children. Annu Proc Assoc Adv Automot
Med. 2007; 51: 81-96.
Oxley J, Congiu M, Whelan M, D’Elio A,
Charlton J. Teaching young children to
cross roads safely. Annu Proc Assoc Adv
Automot Med. 2008; 52: 215-23.
Paulozzi LJ. United States pedestrian fatality
rates by vehicle type. Inj Prev. 2005; 11(4):
232-236.
Peng RY, Bongard FS. Pedestrian versus
motor vehicle accidents: an analysis of
5,000 patients. J Am Coll Surg. 1999;
189(4): 343-348.
Pitt R, Guyer B, Hsieh CC, Malek M. The
severity of pedestrian injuries in children:
An analysis of the Pedestrian Injury
Causation Study. Accid Anal Prev. 1990;
22(6): 549-559.
Plurad D, Demetriades D, Gruzinski G, et
al. Pedestrian injuries: the association of
alcohol consumption with the type and
severity of injuries and outcomes. J Am
Coll Surg. 2006; 202(6): 919-927.
Poulos RG, Hayen A, Finch C, Zwi A. Area
socioeconomic status and childhood injury
morbidity in NSW. Inj Prev. 2007; 13: 322327.
Preusser DF, Well JK, Williams AF et al.
Pedestrian crashes in Washington, DC and
Baltimore. Accid Anal Prev. 2002; 34: 703710.
PROMISING Measures for pedestrian safety
and mobility problems. Final report of
workpackage 1. NTUA National Technical
University of Athens, Greece. 2001. http://
ec.europa.eu/transport/roadsafety_library/
publications/promising_deliverable_1.pdf
Redelmeier DA, Tibshirani RJ. Association
between cellular-telephone calls and motor
vehicle collisions. N Engl J Med. 1997;
336(7): 453-458.
Retting RA, Ferguson SA, McCartt AT. A
review of evidence-based traffic engineering
measures designed to reduce pedestrianmotor vehicle crashes. Am J Public Health.
2003;93(9):1456-1463
Rifaat SM, Chin HC. Accident severity
analysis using ordered probit model. J Adv
Transport. 2007; 41(1): 91-114.
Roudsari B, Mock C, Kaufman R.An
evaluation of the association between
vehicle type and the source and severity of
pedestrian injuries. Traffic Inj Prev. 2005;
6(2): 185-192.
Roudsari B, Kaufman R, Koepsell T. Turning
at intersections and pedestrian injuries.
Traffic Inj Prev. 2006; 7(3): 283-289.
Ryb GE, Dischinger PC, Kufera JA,
et al. Social, behavioral and driving
characteristics of injured pedestrians: a
comparison with other unintentional trauma
patients. Accid Anal Prev. 2007; 39(2): 313318.
Sandt L, Zegeer C. Characteristics Related to
Midblock Pedestrian—Vehicle Crashes and
Potential Treatments. Transport Res Rec.
2006; 1982(1): 113-121.
Schwebel DC, McClure LA. Using virtual
reality to train children in safe street
crossing skills. Inj Prev 2010; 16(1); e1-5.
Shults RA, Nichols JL, Dinh-Zarr TB, et
al. Effectiveness of primary enforcement
safety belt laws and enhanced enforcement
of safety belt laws: A summary of the
Guide to Community Preventive Services
systematic reviews. J Safety Research 2004;
34: 189-196.
Small TJ, Sheedy JM, Grabs AJ. Cost,
demographics and injury profile of adult
pedestrian trauma in inner Sydney. ANZ J.
Surg. 2006; 76: 43-47.
Starnes MJ, Hadjizacharia P, Chan LS, et al.
Automobile versus pedestrian injuries: does
gender matter? J Emerg Med. 2008; [Epub
ahead of print].
Stavrinos D, Byington KW, Schwebel DC.
Effect of cell phone distraction on pediatric
pedestrian injury risk. Pediatrics. 2009;
123(2): e179-185.
Sze NN, Wong SC. Diagnostic analysis of the
logistic model for pedestrian injury severity
in traffic crashes. Accid Anal Prev. 2007;
39(6): 1267-1278.
Telstra. Telstra, police & NRMA Insurance
join forces to target mobile phone use on
Australian Roads. Telstra News Release,
2003 www.telstra.com.au/newsroom.
VICTORIAN INJURY SURVEILLANCE UNIT
Thomson JA, Tolmie AK, Foot HC, Whelan
KM, Sarvary P, Morrison S. Influence
of virtual reality training on the roadside
crossing judgments of child pedestrians. J
Exp Psychol Appl. 2005; 11(3): 175-186.
Timperio A, Crawford D, Telford A, Salmon J.
Perceptions about the local neighbourhood
and walking and cycling among children.
Prev Med. 2004; 38(1): 39-47.
Transport Accident Commission. Pedestrian
Statistics.
www.tacsafety.com.au/jsp/
content/NavigationController.do?areaID=1
2&tierID=1&navID=57348A10&navLink=
null&pageID=149. Accessed 17/6/2010.
Unger R, Eder C, Mayr JM, Wernig J. Child
pedestrian injuries at tram and bus stops.
Injury. 2002; 33(6): 485-488.
VicRoads Safety Rules. Mobile phones
and Visual Display Units. http://
w w w. v i c r o a d s . v i c . g o v. a u / H o m e /
SafetyAndRules/RoadRules/
MobilePhonesandvisualdisplayunits.htm.
Accessed 9/6/2010
Violano P, Davis KA, Lane V, Lofthouse
R, Carusone C. Establishing an injury
prevention program to address pediatric
pedestrian collisions. J Trauma Nurs
2009;16(4):216-219
Walkinginfo website (2009). Retrieved
18 September 2009 from: http://www.
walkinginfo.org/why/
Yannis, G, Kanellaidis G, Dimitropoulos
J, et al. Assessment of pedestrian safety
measures in Europe. ITE. 2007; 77(12): 4048.
Zajac SS, Ivan JN. Factors influencing
injury severity of motor vehicle-crossing
pedestrian crashes in rural Connecticut.
Accid Anal Prev. 2003; 35(3): 369-379.
Zegeer CJ, Stewart RJ, Huang H, et al.
Safety effects of marked versus unmarked
crosswalks at uncontrolled locations:
analysis of pedestrian crashes in 30 cities.
Transport Res Rec. 2001; 1773(-1): 56-68.
HAZARD 72
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BOX 1 Database and case selection
The National Coronial Information System (NCIS)
The main source of death data is the NCIS. The NCIS is a national internet based data storage and retrieval system for
Australian coronial cases. Details of the data collection system and data fields are available on the NCIS website.
www.vifp.monash.edu.au/ncis/. The NCIS was accessed by Angela Clapperton (VISU researcher and co-author of the
report) who has a user licence.
Case selection
For the main analyses, cases were selected from the NCIS. Only ‘closed’ traffic-related pedestrian fatalities were selected,
11 additional traffic-related fatalities were found but excluded as coronial investigations were still open. Cases were
selected using the following variables:
1.
2.
3.
4.
5.
Case type on completion = death due to external causes
Intent type on completion = unintentional
Case jurisdiction = Victoria
Mechanism of injury = blunt force > transport injury event > pedestrian
Case year = 2006-2008
After initial selection, cases were further examined then excluded if the cause of death was recorded as due to:
•
suicide;
•
a medical condition; or
•
a collision with a railway vehicle that occurred off-road
OR
•
if the on-road death of a user of a pedestrian conveyance (mobility scooter, wheelchair, skateboard, inline skates, toy
scooter etc.) was due to a fall or other cause unrelated to a collision with a motor vehicle or other form of on-road
transport.
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
page 13
Appendix 1
Table A Common pedestrian safety measures: aim of measure and effectiveness
Area
Aim of measure
Effectiveness
Managing
Reducing
Facilitating
Enhancing
Increasing
Special
Safe
Low /
High cost
Vehicle
pedestrian
pedestrians
visibility
environment’s
road
behaviours
moderate
– High /
speeds
exposure
movements
readability
users
cost – High /
moderate
moderate
effectiveness
Engineering
Measure
effectiveness
Sidewalks and
walkways
3
3
3
3
Curb ramps
3
3
3
Marked crosswalks
and enhancement
3
3
3
3
Transit stop
treatment
3
3
3
Roadway lighting
improvements
3
3
Pedestrian barriers
and fencing
3
3
3
Pedestrian
overpass/underpass
3
3
Street
furniture/walking
environment
3
3
Bicycle lane
3
Roadway narrowing
3
3
3
Lane reduction
3
3
Driveway
improvements
3
3
Raised medians
3
3
3
One-way/two-way
street conversions
3
3
3
Curb radius
reduction
3
3
Improved left-turn
slip-lane design
3
3
3
Roundabouts
3
3
Modified
T-intersections
3
3
3
Intersection median
barriers
3
3
Curb extension
3
3
3
Chokers
3
3
Crossing islands
3
3
Chicanes
3
3
3
3
3
3
3
3
Mini-circles
Speed humps
Speed tables
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
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3
page 14
Appendix 1 (cont...)
Table A Common pedestrian safety measures: aim of measure and effectiveness
Area
Aim of measure
Effectiveness
Managing
Reducing
Facilitating
Enhancing
Increasing
Special
Safe
Low /
High cost
Vehicle
pedestrian
pedestrians
visibility
environment’s
road
behaviours
moderate
– High /
speeds
exposure
movements
readability
users
cost – High /
moderate
moderate
effectiveness
Education
Engineering
Measure
Enforce
ment
effectiveness
Raised intersections
3
3
Raised pedestrian
crossings
3
3
3
3
Gateways
3
3
3
Landscaping
3
3
3
Specific pavement
treatment
3
3
3
Serpentine design
3
3
Woonert
3
3
3
3
Diverters
3
3
Full street closure
3
3
Partial street closure
3
3
Pedestrian
streets/malls
3
3
Traffic signals
3
3
3
Pedestrian signals
3
3
3
Pedestrian signal
timing
3
3
3
Traffic signal
enhancements
3
3
3
Left-turn-on-red
restrictions
3
3
Advanced stop lines
3
3
Signing
3
3
School zone
improvement
3
3
3
3
Neighbourhood
identity
3
3
Speed-monitoring
trailer
3
3
On-street parking
enhancements
3
3
Friendly vehicle
fronts
3
3
Pedestrian
education
3
3
Driver education
3
3
Special group
education
3
3
Enforcement
3
3
VICTORIAN INJURY SURVEILLANCE UNIT
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Appendix 2
Table B
Recommended pedestrian safety countermeasures
Pedestrian safety issues
Recommended pedestrian safety countermeasures
POPULATION GROUPS
• Refuge islands to make crossing task easy for the elderly
• More elderly-friendly footpaths and crossings
• Changing behaviour of younger drivers toward the elderly
• Traffic safety education
• Providing more pedestrian crossings
• Longer green light cycles
Elderly pedestrians
Adolescents and young adults (15-29)
• Traffic calming measures in residential areas
• Traffic safety education
(see below for alcohol/drug users)
Heavy or binge users of alcohol and/
or drugs
• Traffic restraints such as street closures in high-alcohol-consumption
areas during high-alcohol hours
• Side-walk barriers to deter pedestrians from jay-walking or exiting
pubs/clubs directly onto road
• All-red signal design for intersections located near to licensed alcohol
dealers
• More alcohol sobriety checks and testing
• Installing more alcohol-testing devices in premises alcohol is served
• Improved provision of night-time public transport or taxi services
especially in rural areas
Persons born in non-English speaking
countries, tourists and visitors
• Provide educational material (leaflets and posters) in English and main
languages of visitors at entry points to Victoria such as airports,
visitor information centres at state borders, main train stations and
tourist accommodation
• Provide education and training in road crossing behaviour for new
arrivals (students and migrants)
• Improve signings and markings to increase the readability of the
environment
Students and children
• Traffic calming measures in residential areas and around schools
• School crossing patrol
• Close supervision of children in vicinity of roads
• Traffic safety education and training
• 30 km/hr speed zones in high pedestrian areas
CRASH TYPE
‘Crossing the road’ crashes
VICTORIAN INJURY SURVEILLANCE UNIT
• Relocate bus/tram stops where warranted
• Improve/add night time lighting
• Install overpass or underpass
• Install medians or pedestrian crossing islands
• Provide curb extensions at intersections or midblock to improve direct
line of sight between vehicle and pedestrian
• Apply traffic calming measures
• Provide staggered crosswalk through the median
• Install midblock traffic signal with pedestrian signals, if warranted
• Adjust school district boundaries
• Use speed-monitoring trailer
• Enforce speed limits, pedestrian ordinances
• Reduce road width
• Narrow travel lanes
HAZARD 72
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Appendix 2 (cont...)
Table B
Recommended pedestrian safety countermeasures
Pedestrian safety issues
Recommended pedestrian safety countermeasures
Speeding and high-impact speed
crashes
• Modern roundabouts
• Speed-limiters in vehicles
• Anti-skid road surfaces and anti–skid technologies for vehicles
• Equipping vehicles with intelligent pedestrian-detectors
• 30 km/hr speed zones in high pedestrian areas
• Police enforcement and speed cameras
Visibility and conpiscuity–related
crashes
• Signing and pedestrian marking
• Pedestrian zones and streets
• Providing good street lighting
• Special lighting at pedestrian crossings and intersections
• Removing visual obstacles
• Pedestrian wearing conspicuous clothing (retroreflective jackets
bands)
‘Trapped pedestrians’ crashes
• Relocate bus stop to far side of crossing area
• Improve roadway lighting
• Provide midblock or intersection curb extensions
• Install traffic calming devices such as speed tables or raised
pedestrian crossings on local and neighborhood streets
• Provide raised crosswalks to improve pedestrian visibility
• Install traffic signals if warranted, including pedestrian signals
• Install flashers or advance warning signs
• Recess stop lines
• Install barriers or signs to prohibit crossings and direct pedestrians to
safer crossing locations nearby
• Enforce crosswalk laws
‘Emerging from between cars’ or
‘dart-out’ crashes
• Provide good nighttime lighting
• Add on-street bike lanes
• Narrow travel lanes
• Provide curb extensions
• Install spot street narrowing at high midblock-crossing locations
• Implement traffic-calming measures such as chicanes, speed humps,
or speed tables
• Provide raised pedestrian crossings
• Design gateway to alert motorists that they are entering neighborhood
with high level of pedestrian activity
• Convert street to driveway link/serpentine, woonerf, or a pedestrian
street
• Install street diverters or full/partial street closures at selected
intersections
• Provide adult crossing guard (in school zone)
• Remove or restrict on-street parking
• Educate children about safe crossing behavior and adults about
speeding
‘Hit while walking on the road’ crashes
• Provide walkable sidewalks
• Provide safer routes to schools
• Provide better street lighting
• Use barriers to keep pedestrians off the road
• Improve public transport and taxi services at night especially in rural
areas
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
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Appendix 2 (cont...)
Table B
Recommended pedestrian safety countermeasures
Pedestrian safety issues
Recommended pedestrian safety countermeasures
‘Hit on driveway’ crashes
• Provide sidewalk or walkway
• Maintain level sidewalks across driveways or alleys
• Provide clear walking path across driveway
• Remove unneeded driveways and alleys
• Remove sight obstructions (e.g., trim hedges or lower fencing)
• Narrow driveways and reduce turning radii
• Add adequate planting strip or sidewalk separation
• Provide advance warning signs for drivers
‘Reversing car’ crashes
• Provide clearly delineated walkways for pedestrians in parking Lots
• Relocate pedestrian walkways
• Improve night time lighting
• Remove unneeded driveways and alleys
• Remove landscaping or other sight obstruction near driveways
• Provide curb extensions or raised pedestrian crossings to improve the
visibility of pedestrians to backing motorists
• Eliminate, modify, or relocate parking if feasible
• Enhance pedestrian education
• Enhance driver education
• Provide auditory backing alert on vehicle.
‘Playing or working on the road’
crashes
• Provide accessible sidewalks or walkways on both sides of street
• Improve street lighting
• Introduce traffic-calming measures (e.g., street narrowing, speed
humps)
• Convert streets to a woonerf or use signs to identify neighborhood as
area with high levels of pedestrian activity
• Consider street closures (full or partial) or use diverters
• Implement pedestrian and motorist education programs
• Provide community park/playground
• Improve lighting around workers and wearing of retroreflective
garments by workers
• Improve traffic control measures (e.g., signs, markings, cones,
barricades, and flashers) warning motorists of workers’ presence
• Increase worker safety training
• Increase police enforcement of speed limits in work zones
• Provide better physical separation/protection of worksite from motor
vehicles
‘Hit while boarding/alighting’ crashes
• Improve road lighting
• Restrict on-street parking near bus/tram stops
Heavy (bus, truck, tram etc.) and
semi-heavy (light trucks and 4WD
vehicles) vehicle-related crashes
• Pedestrian-friendly vehicle front design (applicable to all vehicle fleet),
e.g. removing roo-bars from the front of heavy and semi-heavy
vehicles transiting in cities
• Heavy vehicle ban in high-pedestrian zones
Motorcycles and bicycle–related
crashes
• Bike lanes
• Improved signage and centre line marking on shared pathways
VICTORIAN INJURY SURVEILLANCE UNIT
HAZARD 72
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- INDEX Subject.....................................................Edition
Asphyxia..............................................................................................60
Babywalkers, update.............................................................16,20,25,34
Baseball................................................................................................30
Boating-related recreational injury.....................................................56
Bunkbeds.............................................................................................11
Bicycles - Bicycle related..................................................6,31,34,44,65
- Cyclist head injury study......................................................2,7,8,10
Burns - Scalds, Burns prevention.................................................3,12,25
- Unintentional burns and scalds in vulnerable populations...........57
Child care settings................................................................................16
Client survey results.............................................................................28
Cutting and piercing (unintentional) assaultive.............................52, 55
Data base use, interpretation & example of form..................................2
Deaths from injury (Victoria)..........................................................11,38
Dishwasher machine detergents - Update............................................18
DIY maintenance injuries....................................................................41
Dog bites, dog related injuries......................................3,12,25,26,34,69
Domestic architectural glass........................................................7,22,25
Domestic Violence..........................................................................21,30
Drowning/near drowning, including updates....................2,5,7,30,34,55
Elastic luggage straps...........................................................................43
Escalator...............................................................................................24
Exercise bicycles, update....................................................................5,9
Falls - Child, Older Persons, Home......................................44,45,48,59
Farm, Tractors..................................................................30,33,24,47,68
Finger jam (hand entrapment)..........................................10,14,16,25,59
Fireworks.............................................................................................47
Geographic regions of injury...............................................................46
Home....................................................................................14,32,59,65
Horse related.....................................................................................7,23
Infants - injuries in the first year of life.................................................8
Injury surveillance developments, inc. ICD10 coding....................30,43
Intentional............................................................................................13
Latrobe Valley
- First 3 months, Injury surveillance & prevention
....................................................................9, March 1992, Feb 1994
VICTORIAN INJURY SURVEILLANCE UNIT
Ladders.................................................................................................63
Lawn mowers.......................................................................................22
Marine animals.....................................................................................56
Martial arts...........................................................................................11
Mobility scooters.................................................................................62
Motor vehicle related, non-traffic, vehicle jack injuires.................20,63
Motorcycles.....................................................................................64,65
Needlestick injuries....................................................................11,17,25
Nursery furniture.............................................................................37,44
Older people.........................................................................................19
Off-street parking areas........................................................................20
Pedestrians......................................................................................71,72
Playground equipment...................................3,10,14,16,25,29,44,61,65
Poisons - Domestic chemical and plant poisoning..............................28
- Drug safety and poisons control......................................................4
- Dishwasher detergent, update.....................................................10,6
- Early Childhood, Child Resistant Closures...........................27,2,47
- Adult overview...............................................................................39
Power saws, Chainsaws..................................................................22,28
Roller Blades, Skateboards..................................................2,5,25,31,44
School..................................................................................................10
Shopping trolleys.......................................................................22,25,42
Smoking-related....................................................................21,25,29,44
Socio-economic status and injury..................................................49, 70
Sports - child sports, adult sports, surf sports,
snow sports............................................................8,9,44,15,51,56,66
Suicide - motor vehicle exhaust gas......................................11,20,25,41
Trail bikes............................................................................................31
Trampolines...............................................................................13,42,61
Trends in road traffic fatality and injury in Victoria.......................36,65
Vapouriser units...................................................................................43
Venomous bites and stings...................................................................35
VISS: How it works, progress, A decade of Victorian injury
surveillance..............................................................................1,26,40
VISAR: Celebration of VISAR’s achievements,
VISAR name change to VISU....................................................50,61
Work-related..............................................................................17,18,58
HAZARD 72
page 19
Acknowledgements
Contact VISU at:
Guest Editors
MUARC - Accident Research Centre
Building 70
Monash University
Victoria, 3800
VISU Staff
Phone:
Enquiries (03) 9905 1805
Co-ordinator (03) 9905 1805
Director (03) 9905 1857
Fax (03) 9905 1809
Email: visu.enquire@monash.edu
Dr Jennie Oxley, Monash University Accident Research Centre (MUARC)
Ms Jessica Pearce, National Coroners Information System (NCIS)
Director: Research Fellows: Research Officers: Ms Erin Cassell
Ms Karen Ashby
Ms Angela Clapperton
Mr Nicholas Reid
Ms Emily Kerr
Participating hospitals
From October 1995
Austin & Repatriation Medical Centre
Ballarat Base Hospital
The Bendigo Hospital Campus
Box Hill Hospital
Echuca Base Hospital
The Geelong Hospital
Goulburn Valley Base Hospital
Maroondah Hospital
Mildura Base Hospital
The Northern Hospital
Royal Children’s Hospital
St Vincents Public Hospital
Wangaratta Base Hospital
Warrnambool & District Base Hospital
Western Hospital - Footscray
Western Hospital - Sunshine
Williamstown Hospital
Wimmera Base Hospital
From November 1995
Dandenong Hospital
From December 1995
Royal Victorian Eye & Ear Hospital
Frankston Hospital
From January 1996
Latrobe Regional Hospital
From July 1996
Alfred Hospital
Monash Medical Centre
From September 1996
Angliss Hospital
From January 1997
Royal Melbourne Hospital
All issues of Hazard and other
information and publications of
the Monash University Accident
Research Centre can be found on our
internet home page:
www.monash.edu.au/muarc/visu
From January 1999
Werribee Mercy Hospital
From December 2000
Rosebud Hospital
From January 2004
Bairnsdale Hospital
Central Gippsland Health Service (Sale)
Hamilton Base Hospital
Royal Women’s Hospital
Sandringham & District Hospital
Swan Hill Hospital
West Gippsland Hospital (Warragul)
Wodonga Regional Health Group
VISU is a project of the Monash
University Accident Research Centre,
funded by the Department of Health
Hazard was produced by the
From April 2005
Casey Hospital
How to access VISU data:
VISU collects and analyses information on injury problems to underpin the
development of prevention strategies and their implementation. VISU analyses are
publicly available for teaching, research and prevention purposes. Requests for
information should be directed to the VISU Co-ordinator or the Director by contacting
them at the VISU office.
VICTORIAN INJURY SURVEILLANCE UNIT
Victorian Injury Surveillance Unit
(VISU)
Illustrations by Debbie Mourtzios
ISSN-1320-0593
Printed by Work & Turner Pty Ltd,
Tullamarine
Layout by Inspired by Graphics,
Caroline Springs
HAZARD 72
page 20