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Overview of traffic-related pedestrian and bicyclist injuries in Hawaii

Dan GalanisInjury Prevention and Control Program

Hawaii Department of Health1250 Punchbowl St., Room 214

Honolulu, HI 96813Ph: 586-5943

E-mail: daniel.galanis@doh.hawaii.gov

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Overview of presentation

• Fatal traffic crashes – State/national comparisons (CDC data)

– Overall data (FARS) • Trends, county comparisons

• Contributing factors: speeding, alcohol use, helmets, time,

• Non-fatal traffic crashes – County comparisons, trends, age, contributing factors

• MVAR/DOT crash data

– Descriptions of injuries• Hospital and emergency department (ED) records

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Pedestrian fatality rates (/million residents), by state, 2000-2004

0

50

100

150

0

50

100

150

200

250

300

350

400

HI

All ages: Pedestrian fatality rate for Hawaii: 115.7 (5th nationally)Rate for rest of U.S.: 84.7/million

Rate/

million

HI

Rate/

million

Ages 65+ years: Pedestrian fatality rate for Hawaii: 396.7 (1st nationally)Rate for rest of U.S.: 142.6/million

46% HI fatalities are seniors

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Annual number of traffic-related pedestrian fatalities in Hawaii, by county and age group, 2001-2006

0

5

10

15

20

25

30

35

40

1 0 0 0

3 2

14 13

5

9

13 11

1 0

2

0

3 1

2 1

0

15 16

6

12

17 15

4 3

6

1

7 6

23 22

13

24 26

20

2 1

2 3

5

1

4

1

4

30 30

20

31

35

32

Hawaii 27 deaths (15%) 6 seniors (7%)

01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06

all ages

ages 65+

Honolulu 128 deaths (72%) 65 seniors (80%)

Kauai 5 deaths (3%) 3 seniors (4%)

Maui 18 deaths (10%) 7 seniors (9%)

state 178 deaths

81 seniors (46%)

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RISK FACTORS from FARS, 2001-2005 for fatally injured pedestrians

• Peak times– 5:30 a.m. to 7:30 a.m.: 28 deaths (19%)

• Most (71%) were senior-aged victims

– 6:30 p.m. to 9:30 p.m.: 36 deaths (25%)• Most (61%) were under 60 years of age

• Alcohol– Involved in at least 23% of deaths (26% of those tested)

• 18% of pedestrians positive for alcohol (15% >0.11 BAC)

– Involved in 50% of nighttime (8:30pm to 3:30am) crashes• 38% of pedestrians positive for alcohol (30% >0.13 BAC)

– Alcohol use more common among• younger: 32% for victims under age 65 vs. 5% for seniors• male victims: 27% vs. 7% for females• Hawaii County victims: 39%

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Pedestrian fatalities in Hawaii, 2001-2005: Alcohol involvement, by time of crash and age of victim.

0 10 20 30 40 50 60 70 80 90 100 AGE

6:00am

9:00am

noon

3:00pm

9:00pm

mid-night

3:00am

Approximate time of crash

6:00pm

5:00am

Legend: red = alcohol-related (x=ped, square=driver) green = no alcohol in crash blue = unknown

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RISK FACTORS from FARS, 2001-2005 for fatally injured pedestrians (cont.)

• Environment– Two-thirds (64%) hit on non-junction sections of road

• 35% in intersections

– Around one-fourth (27%) in crosswalks, 19% at intersections• 51% hit outside of crosswalk or intersection• Senior-aged victims more likely to be hit in crosswalks (38%) and

intersections (52%)

– Almost half (46%) occurred on 25 mph road or lower• Only 16% were 40 mph or faster

• Contributing factors– 60% of pedestrians erroneously in roadway

• Most commonly improper crossing, “jaywalking” (36%)

– 47% of drivers made errors• Most commonly being “inattentive (26%), or “failure to yield right of way”

(16%), or speeding (11%)

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Non-fatal pedestrian crashes in Hawaii, 2001-2005

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The “injury pyramid” for pedestrian injuries in Hawaii, 2001-2005

Deaths1

(30/yr.)

Hospitalizations6 : 1 death(~190/yr.)

Emergency department visits15 : 1 death(~450/yr.)

Traffic crashes (police attended)18 : 1 death

(~500/yr., including 180 “possible” injuries)

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Annual number of non-fatal traffic-related pedestrian crashes in Hawaii, by county, 2001-2005

0

100

200

300

400

500

600

45 46 54 41 39

425

458

427 456

477

10 13 18 14 4

38 52

37 26 22

518

569

536 537 542

Hawaii 8% overall

Honolulu 83%

Kauai 2%

Maui 6%

state 540/year

’01 ’02 ’03 ’04 ‘05 ’01 ’02 ’03 ’04 ‘05 ’01 ’02 ’03 ’04 ‘05 ’01 ’02 ’03 ’04 ‘05 ’01 ’02 ’03 ’04 ‘05

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Time of day non-fatal traffic-related pedestrian crashes in Hawaii, 2001-2005

1%

2%

3%

5%

6%

7%

1.5 1.5 1.4

0.7 0.7 1

3.5

5.9 6.2

4

4.7

5.1

4.5 4.8

6.7 6.5

6.3

7.5

6.3 6.2

5.2

3.6

3.1 3.2

mid-night 2 3 4 5 6am 7 8 9 10 11 noon 13 14 15 16 17 6pm 19 20 21 22 23

% o

f to

tal

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Number and rate of non-fatal traffic-relatedpedestrian crashes in Hawaii, 2001-2005

0

50

100

150

200

250

300

350

90

214

312

234

180

156 147

166 175

186 174

138 144

98

114

85

58 53

10.6

27.2 37.2

27.6 20.5 19.6 17.7 18.8 18.5 19.8 19.4 18.4

26 23.9 29 22.3 21.4 22.5

25 to 29

20 to 24

35 to 39

30 to 34

45 to 49

40 to 44

55 to 59

50 to 54

65 to 74

60 to 64

75 to 84

85 +

yrs.

15 to 19

10 to 14

5 to 9

<1 to 4

Rate (/10,000)

Number of pedestrians

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Length of stay for patients with non-fatal pedestrian injuries in Honolulu County, by age group, 2003-2005.

25%

50%

75%

100%

0-14y 15-29y 30-44y 45-64y 65-74y 75-84y 85+y

0 -2 days/ED 3 -7 days >1 week/died

88%

8%

4%

44%

20%

35%

51%

11%

38%

65%

11%

24%

78%

11%

11%

79%

10%

11%

87%

8%

5%

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Non-fatal traffic-related pedestrian crashes in Hawaii, 2001-2005: Contributing factors, pedestrian vs. drivers.

Improper Turn

Disregard Controls

Alcohol

Excessive Speed

Misjudgement

Failure to Yield

Inattention

Clothing not Visible

Alcohol

Misjudgement

Inattention

Illegally in Roadway

0.4

1.2

1.5

1.9

7.9

12.9

34.1

1.6

2.8

6.6

15.8

18.3

10% 20% 30%

pedestrian error (33%)

driver error (47%)

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Who? Age: 65 and older for fatalities, 5-14 year-olds and seniors for non-fatal crashes. Gender: fairly equal distribution.

Where? Honolulu has slightly higher rates of fatal injuries among seniors and non-fatal injuries among all ages.

Usually not in intersections, not in crosswalks

When? Morning rush hour and 2:00-6:00 p.m.

Why? FARS: Contributing factors roughly equal between pedestrians (jaywalking), and drivers (failure to yield, inattentive). Alcohol also a factor, especially in night time crashes.

Summary of pedestrian injury data.

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Bicycle crashes in Honolulu County, 2001-2005

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Bicyclists fatality rates (/million residents), by state, 2000-2004

0

5

10

15

20

25

30

35

40

HI

Bicyclist fatality rate for Hawaii: 23.5 (2nd nationally)Rate for rest of U.S.: 12.2/million

Rate/

million

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The “injury pyramid” for bicyclist injuries in Hawaii, 2001-2005

Deaths1

(6/yr.)

Hospitalizations9 : 1 death(~50/yr.)

Emergency department visits37 : 1 death(~205/yr.)

Traffic crashes (police attended)57 : 1 death

(~315/yr., including 100 “possible” injuries)

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Annual number of traffic-related bicyclist injuries in Hawaii, by county and severity, 2001-2006

0

50

100

150

200

250

300

350

1 1 2 1 0 3 2 3 6 2 4 1 1 0 4 1 1 0 8 4 6 7 4 4

32 23

32 41

29

195

226 235

255 246

10 15 7 13 11

43 48 47 31

43

280

312 321

340 329

Hawaii 31 non-fatal/yr (10%) 5 deaths total (15%)

01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06 01 02 03 04 05 06

deaths

Honolulu 231 non-fatal (73%)

20 deaths (61%)

Kauai 11 non-fatal (4%)

2 deaths (6%)

Maui 42 non-fatal (13%)

6 deaths (18%)

state 316 non-fatal/yr 33 total deaths

non-fatal

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Fatal and non-fatal traffic-related bicyclist crashes in Hawaii, 2001-2005

• No trends– Fatal injuries: 29 total, 6 per year on average (4 in 2006)

• From 1997-2000 there were only 4, one in every year– Non-fatal: average of 315/year, 216 with definite injuries

• Demographics:– Average age: 32 years (41 for fatally injured)

• 22% 15 years or younger, half (48%) under 30 (only 3% seniors)– Mostly males (73%)

• Temporal:– Peak times: 7:30-8:30 am (7%), 2:30-6:30 pm (34%)– No seasonality (month), or day-of-week patterns

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Number and rate of non-fatal traffic-related bicycle injuries in Hawaii, by severity of injury, 2001-2005

0

50

100

150

200

250

3

126

208

118

178

140 135 138

142 147

121

62

39 31

8 7 2 4 4

160

248

139

202

176

162 156

150 157

135

83

71 75

20 18 7

17

2

104

166

105

135

117

96 101 100

113

94

59 47 51

13

25 to 29

20 to 24

35 to 39

30 to 34

45 to 49

40 to 44

55 to 59

50 to 54

65 to 69

60 to 64

75 to 79

85 + yrs.

15 to 19

10 to 14

5 to 9

<1 to 4

rate of definite injury

total rate (/100,000)

total number

80 to 84

70 to 74

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Fatal and non-fatal traffic-related bicycle crashes in Hawaii, 2001-2005

• Alcohol– Involved in 6 of the 29 deaths (21%)

• 4 cyclists positive, 3 with BAC 0.12% or higher

• Helmet use:– Fatal crashes: only 5 of the riders (17%) – Non-fatal crashes: 35% of riders

• Environment:– About half (46%) at intersections, 35% on roadway not at intersection, 10% in driveways– Almost all (89%) on urban roads– Actions (non-fatals): 38% riding in roadway, 37% crossing roadway, 7% outside

roadway– Fatal crashes: 31% were 25mph zones or lower, 34% were 35mph, 21% were 40 mph or

higher

• Contributing factors:– Bicyclists: 22% inattention, 12% misjudgement, 8% illegal in roadway, 17% other

unspecified “bicycle violation”– Drivers: 35% inattention, 16% failure to yield, 11% misjudgement, speeding 1.5%