Magnitude and categories of pedestrian fatalities in South Africa

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Abstract

Road traffic injuries, a major global public health burden, are concentrated in low-income and middle-income countries.1 In contrast to high-income countries, pedestrians make up the largest group of road traffic injuries and fatalities in low- and middle-income countries. This article presents an analysis of pedestrian fatalities (2001–2004) in four South African cities. The article describes the magnitude, demographic, and temporal factors associated with pedestrian fatalities and presents a typological analysis to identify particular groups of at risk pedestrians. The analysis can serve to inform the development of prevention programmes tailored to the needs of specific at risk pedestrian groups. Data were obtained from the National Injury Mortality Surveillance System (NIMSS). The results indicated that there were a total of 7433 pedestrian deaths (2001–2004) for the four cities and the majority occurred over weekends. Most (56.7%) were between ages 20 and 44 years. Overall, there were 3.3 male pedestrian deaths for every female pedestrian death, and over half (58%) of the 4004 cases tested were positive for alcohol. A typological analysis identified three categories of pedestrian fatalities: (1) male pedestrian fatalities that showed high levels of alcohol concentrations, (2) female and elderly pedestrian deaths that occurred between 6 AM and midday, and (3) children, adolescents, and young adult pedestrian fatalities that typically occurred during weekday afternoons and evenings. The findings call for multiple strategies for combating pedestrian fatalities.

Introduction

The World Report on Traffic Injury Prevention indicated that of the 1.2 million people killed in road traffic crashes in 2002, 90% of these traffic deaths occurred in low- and middle-income countries (Peden et al., 2004). Compared to other road users, pedestrians, cyclists and motorcyclists bear a high burden of injuries and fatalities arising from road traffic crashes. Pedestrians, cyclists and motorcyclists also usually suffer the most severe types of injuries and have increased medical problems that require extensive assistance (Mayou and Bryant, 2003). In low- and middle-income countries in particular, pedestrians account for the major proportion of road-traffic injuries and fatalities (Afukaar et al., 2003). For instance, Odero et al. (1997) found that in Africa, pedestrians accounted for a major proportion of traffic-related fatalities, with estimates ranging between 39% in Tanzania and 75% in Cote d’Ivoire. In contrast to high-income countries where young children and the elderly constitute the most vulnerable pedestrian fatality groups (Assailly, 1997, Fontaine and Gourlet, 1997, Harruff et al., 1998, Öström and Eriksson, 2001), in low- and middle-income countries pedestrian injuries affect the economically productive age group (15–44 years) (Odero et al., 1997). Pedestrian deaths in the economically productive group impact on household- and country-level economies (Hijar et al., 2003, Nantulya and Reich, 2003, Peden et al., 2004).

In South Africa, estimates reveal that pedestrian fatalities, and road traffic crashes in general, remain a serious problem (Arrive Alive, 2005, Matzopoulos, 2004). The Arrive Alive Safety Campaign, launched in 1997, and one of the major road traffic safety projects implemented by the Department of Transport revealed a steady increase in the number of road traffic-related fatalities over the past years with 11,201 fatalities recorded for 2001, 12,198 for 2002, and 12,353 for 2003 (Arrive Alive, 2005). Pedestrians constitute the largest proportion of all traffic-related fatalities. For instance, the National Injury Mortality Surveillance System (NIMSS) indicated that pedestrians accounted for 40% of the recorded 6689 transport-related deaths in 2003 (Matzopoulos, 2004). Accordingly, the control and prevention of pedestrian injuries in low- and middle-income countries, such as South Africa, should be a high public health priority.

This article presents an analysis of pedestrian fatalities (2001–2004) for four South African cities. The article describes the magnitude, demographic, and temporal factors associated with pedestrian fatalities and presents a typological analysis to identify particular groups of pedestrian fatalities. The article aims to provide a better understanding of the profiles associated with pedestrian fatalities so as to inform the development of pedestrian safety measures that are sensitive to the needs of various pedestrian groups at risk.

Section snippets

Study site

Data were obtained from the National Injury Mortality Surveillance System for the 2001–2004 period. For this study, we identified all deaths classified as pedestrian traffic fatalities, and selected data for four major cities namely, Pretoria, Johannesburg, Durban and Cape Town where the NIMSS has full coverage of non-natural fatalities.

Data instrumentation and collection procedures

The NIMSS uses existing medico-forensic investigative procedures, namely post-mortem reports, police investigative records, chemical pathology laboratory

Results

A total of 7433 pedestrian deaths were registered at the mortuaries in the four cities for the January 2001–December 2004 period. The largest number of pedestrian deaths were recorded for Cape Town (2231), followed by Durban (2171), Johannesburg (2119), and then Pretoria (956).

We note from Table 1 that the pedestrian mortality rate for Cape Town decreased from 20.7/100,000 in 2001 to 17.3/100,000 in 2003, and then increased to 19.3/100,000 in 2004. Durban, on the other hand, witnessed an

Discussion

The results of our study indicated that there were 7433 pedestrian deaths (2001–2004) in the four major cities in South Africa. As such our data echoed studies that have identified pedestrians as a vulnerable group for traffic related injuries in low- and middle-income countries and that have indicated pedestrian fatalities as constituting the largest proportion of all traffic related fatalities (Afukaar et al., 2003, Nantulya and Reich, 2003, Odero et al., 1997, Odero et al., 2003). Also,

Conclusion

Our analysis indicates that pedestrians are a particular vulnerable group of road users whose safety requires significant specificity for age, gender, location, time and alcohol or non-alcohol use. Different interventions need to be developed that specifically considers the dimensions associated with each of the three categories of pedestrian fatalities identified in the study. Notwithstanding opposition from alcohol manufacturers and traders legislation to control access to alcohol and

Acknowledgements

The authors wish to acknowledge the forensic pathologists and personnel at the participating mortuaries and forensic chemistry laboratories, who made the data available for the NIMSS.

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    1

    Since the terms “developing” and “developed countries” carry ideological and pejorative connotations we use the terms “high-income” and “low-income” countries instead. Some times we use the term “low-to-middle income countries” as a synecdoche to refer to marginal and emerging economies.

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