They believe that this should form part of an integrated approach from public health, transportation and road safety agencies to address this growing threat.

Among road users, pedestrians are already a group at high risk, and older people are particularly vulnerable, write experts from Trinity College Dublin. People over 60 are more than four times as likely to die if injured by a car than younger people.

In Europe sales of SUVs have increased by 15% in the past year, while sales of standard cars have dropped by 4%. A recent US study found that, for the same collision speed, the likelihood of a pedestrian fatality is nearly doubled in the event of a collision with a large SUV compared with a passenger car. Other studies report higher rates (up to four times) of severe injury and death.

The increased risk from SUVs arises primarily from the geometry of the front end structure, explain the authors. Pedestrian injuries from cars are mainly leg fractures and knee injuries from the primary impact with the bumper and head injuries from the secondary impact with the bonnet or windscreen.

But because SUV bonnets are higher than those of cars, this results in more severe primary impact on the critical central body regions of the upper leg and pelvis, and a doubling of injuries to vulnerable regions such as the head, thorax, and abdomen.

The evidence clearly shows that SUVs represent a significantly greater hazard to pedestrians than ordinary cars and those pedestrians are getting older and more vulnerable, say the authors.

Measures to address this threat should include changing crash investigation processes to identify SUVs in vehicle-pedestrian impact statistics, and displaying warning notices on SUVs to help inform consumers of the incre
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Contact: Emma Dickinson
edickinson@bmj.com
44-20-7383-6529
BMJ-British Medical Journal
6-Oct-2005