Incidence of seriously injured road users in a Swedish region, 2003-2014, from the perspective of a national road safety policy.

Background: Since 1997 Sweden has a policy for road safety called Vision Zero. Given that Vision Zero is mainly used to reduce fatalities among car occupants, the question has been raised by the research community whether a Vision Zero approach promotes health for all road traffic users. The objective is to measure target fulfilment of the national road safety policy for a Swedish region by examining incidence of serious injury during 2003-2014 in rural and urban road spaces with or without implemented measures.

Methods: Data on seriously injured road users, defined as ISS > 8 (Injury Severity Score), were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) together with data from NVDB (National Road Database). These data are used to describe where road users are seriously injured in relation to implemented national policy and using a conceptual model of a road space comprising roads, pavements and tracks for walking and cycling. Seriously injured road users in single and multiple crashes with and without vehicles are included. The development of the incidence is analysed for different road users and places in the road space.

Results: Despite implemented road safety measures in the region, the incidence of seriously injured road users per 100,000 inhabitants in rural areas increased from 7.8 in 2003 to 9.3 in 2014 but doubled in urban areas from 8.0 in to 16.3 respectively. In areas not transformed by Vision Zero, only 36% were injured in rural areas while 64% were injured in urban areas. In contrast, in transformed areas 61% of injuries occurred in rural areas, whereas 39% occurred in urban areas. While the incidence decreased for car occupants on transformed national roads in rural areas, the incidence of serious injuries increased among unprotected road users in urban areas, in particular on pavements and tracks for cycling and walking than on the roads where Vision Zero had been implemented.

Conclusion: The reduction in the incidence for car occupants in the region may not be adequate to contribute to fulfilling the national target. More needs to be done, especially in the urban areas, where more active mobility is desired.