Objective: To investigate the relative likelihood of pedestrian head injuries based on person, vehicular, and environmental factors in China.
Methods: A team was established to collect passenger car-pedestrian accident cases occurring between 2006 and 2011 in Beijing, Shanxi Province, and Chongqing, China. Some key variables for person-, vehicle-, and environment-related factors on head injuries were analyzed using multivariate logistic regression analysis to determine relative risk/likelihood. Pedestrians were classified according to injury outcome and age. Pedestrian head injuries were scored using the Abbreviated Injury Scale (AIS).
Results: A total of 285 vehicle-pedestrian crashes were collected and analyzed: 30 in Beijing, 20 in Shanxi Province, and 235 in Chongqing. The distribution in age and road type by study location differed. The injury outcome, head injury severity, and head contact site were different among 4 age groups. The variables including head contact site and impact speed were the common determinants for head injury severity. A higher pedestrian fatality risk was associated with age over 46, impact speeds over 40 km/h, and higher likelihoods of the victim's head striking the windscreen frame/A pillar and of the victim sustaining a head injury. Similarly, a higher risk of head injury was associated with being female, age over 60, impact speeds over 40 km/h, and a likelihood of the victim's head striking the vehicle rather than the ground. Impact speeds of over 40 km/h and head contact site on windscreen frame/A pillar retained a strong association with severe head injury (AIS 5-6) rate.
Conclusions: Pedestrian age, vehicle impact speed, and head contact site were common pertinent factors for the risk of pedestrian head injury and the risk of death. Further studies would be valuable to fully characterize vehicle-pedestrian crashes in China and to develop targeted injury prevention strategies based on surveillance results.