Elderly in the traffic environment: analysis of fatal crashes in northern Sweden

Fatal crashes of the elderly (> or = 60 years; N = 379) in northern Sweden in the traffic environment, between 1977 and 1986, were investigated using autopsy and police reports. Males had double the death rate of females. The car occupants made up the largest category (43%) followed by pedestrians, pedalcyclists, and two-wheel-motorvehicle (TWMV) riders, but the risk of fatal injury per unit distance travelled was highest for pedestrians and pedalcyclists. Most car occupants were killed in vehicle-vehicle crashes, mostly in the daylight and at intersections or straight roads. Ice and/or snow (31%) was the major precrash factor. In two-thirds of single car crashes, roadside hazards such as trees were involved. Most elderly fatally injured car drivers were responsible for the crash, and they were commonly involved in collisions with oncoming vehicles. Only 4% of the fatally injured car drivers were driving under the influence of alcohol. Head injuries appeared to be more common in side impact than in frontal impacts. Serious chest injuries were more common than head injuries in car crashes. One-quarter of the pedestrians were injured at pedestrian crossings and about half during darkness. One in six pedestrians were under the influence of alcohol. All pedalcyclists were injured in collisions with motor vehicles and most were injured at intersections. Pedestrians, pedalcyclists, and TWMV riders had more serious head injuries than chest injuries.