Analysis of 121 fatal passenger car-adult pedestrian accidents in China Hui Zhao a, * , Zhiyong Yin a , Guangyu Yang a , Xingping Che a , Jingru Xie a , Wei Huang b , Zhengguo Wang a a Chongqing Key Laboratory of Vehicle Crash/Bio-impact and Traffic Safety, Department 4th, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China b Chongqing Traffic Management Administration of Public Security Bureau, Chongqing 402260, China article info Article history: Received 23 March 2014 Received in revised form 22 June 2014 Accepted 6 August 2014 Available online 16 August 2014 Keywords: Pedestrian fatalities Injuries Collision Epidemiology abstract To study the characteristics of fatal vehicle-pedestrian accidents in China，a team was established and passenger car-pedestrian crash cases occurring between 2006 and 2011 in Beijing and Chongqing, China were collected. A total of 121 fatal passenger car-adult pedestrian collisions were sampled and analyzed. The pedestrian injuries were scored according to Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). The demographical distributions of fatal pedestrian accidents differed from other pedestrian ac- cidents. Among the victims, no significant discrepancy in the distribution of ISS and AIS in head, thorax, abdomen, and extremities by pedestrian age was found, while pedestrian behaviors prior to the crashes may affect the ISS. The distributions of AIS in head, thorax, and abdomen among the fatalities did not show any association with impact speeds or vehicle types, whereas there was a strong relationship between the ISS and impact speeds. Whether pedestrians died in the accident field or not was not associated with the ISS or AIS. The present results may be useful for not only forensic experts but also vehicle safety researchers. More investigations regarding fatal pedestrian accidents need be conducted in great detail. © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved. 1. Introduction With the rise in global urbanization and motorization, road traffic accidents (RTAs) induced injuries have become major worldwide public health problems. According to a report by World Health Organization, 1 over 1.2 million people died from RTAs each year in the world and about 50 million were injured. It was pred- icated that the injuries related to RTAs will rise to become the fifth leading cause of death by 2030. 1 Pedestrians, as one of the most vulnerable road users, are accounted for a very high proportion of fatalities involved in RTAs around the world. For example, in the developed countries with high incomes, typically 10e30% of fa- talities related to RTAs are pedestrians. Meanwhile, substantially higher pedestrian fatal proportions were reported in the other countries with middle or low-incomes, despite the figures are underestimated. 1 For experts in forensic medicine, the analysis of causes of in- juries or deaths from RTAs has become a very important part of their daily work. 2e4 Few studies have been performed to investigate the characters of fatal pedestrian accidents, especially for the middle and low income countries, e.g. China, although fatal pedestrian accidents occur very frequently in these countries. 1 It has been suggested that pedestrian injuries can provide evidential value for reconstruction of pedestrian-vehicle accidents at the moment of collision, 5 and that pedestrian injuries maybe a further evaluation index to reconstruct car-to-pedestrian collision. 6 In the authors’ point of view, the injuries sustained by the pedestrians need to be studied in detail from fatal vehicle-pedestrian collisions to reconstruct the collisions. To date, a large number of pedestrian accidents have been investigated worldwide, especially for some developed countries. It has been accepted that real-world vehicle-pedestrian collision data may provide first-hand information about patterns, causation, risk factors of accidents, and valuable background for decreasing pedestrian injuries and deaths. 7 The data are important not only to legal medical experts to validate the vehicle-pedestrian crash reconstruction, but also to researchers to develop the techniques to reduce or prevent such crashes. 8 However, limited research was focused on fatal vehicle-pedestrian accidents in the countries with middle or low incomes. Nowadays, pedestrian accident databases with detailed infor- mation related to crashes and injuries are available for a small * Corresponding author. Tel.: þ86 23 68757446; fax: þ86 23 68816153. E-mail address: box.zhaohui@163.com (H. Zhao). Contents lists available at ScienceDirect Journal of Forensic and Legal Medicine journal homepage: www.elsevier.com/locate/jflm http://dx.doi.org/10.1016/j.jflm.2014.08.003 1752-928X/© 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved. Journal of Forensic and Legal Medicine 27 (2014) 76e81