Swedish Traffic Accident Data Aquisition (Strada)

Swedish Traffic Accident Data Aquisition (Strada)

Strada Experiences from the implementation process Demonstration Research, examples Tomas Fredlund Swedish Transport Agency

Road crash data in Sweden is collected by the police and the emergency hospitals (Strada). Strada offers combined information from both sources in one database.

Together with several other initiatives, Strada has had an impact on Swedish Traffic Safety. It has taken 20 years to implement.

1993 Investigation 1996 Initiation and development 1999 First data collection 2003 Complete coverage by the police 2016 Complete coverage by (70) emergency hospitals

Coverage 100% 90% 91% 93% 96% 96% 100% 80% 83% 70% 60% 58% 62% 67% 73% 50% 40% 37% 40% 40% 47% Policeauthorities (N=21) Hospitals (N=73) 30% 20% 17% 19% 25% 10% 0% 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Personnel Swedish Transport Agency Staff: 12-14 coordinators, statisticians Budget: 26 M Euro Police ~110 administrators Hospitals ~170 nurses, secretaries

Challenges Technology Legislation Financing Endurance

Experiences Extensive cooperation between authorities is possible without legislation. Strada rests on > 100 agreements between authorities. Key factors -Financing -Responsiveness, our users is our system -Strive for high accessibility Free information for users, no license fees, no education fees.

45 000 Number of injured persons (Sw) 40 000 35 000 30 000 25 000 20 000 15 000 10 000 5 000 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Police Police P+S Hospital

45 000 Number of injured persons (Sw) 40 000 35 000 30 000 25 000 20 000 15 000 10 000 5 000 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Police P+S Hospital

Demonstration

What has Strada contributed to? Increased accessibility to relevant information for hundreds of officials and researchers. Changed definition of serious injury, based on hospital-data. More focus on pedestrians, bicyclists.

Research from SAFER Vehicle and Traffic safety centre SAFER is a competence centre where about 30 partners from the Swedish automotive industry, academia and authorities cooperate to create a centre of excellence within traffic safety research and safe mobility.

Prehospital transportation decisions for patients sustaining major trauma in road traffic crashes in Sweden Purpose of the research: To prevent fatalities and mitigate the injury outcome for patients injured in road traffic crashes (RTCs), it is essential to provide adequate medical treatment with minimal delay. A key to achieving this is to correctly decide which medical facility can provide the best initial/definitive treatment for the patient, among the viable alternatives within reach from the scene of the crash. The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes who could benefit from direct transportation to a trauma center (TC). How STRADA was used in the study: A total of 117,730 patients who were transported by road or air ambulance were selectedfrom the Swedish TRaffic Accident Data Acquisition (STRADA) database between 2007 to 2014. An analysis of the patient characteristics sustaining major trauma in comparison with patients sustaining minor trauma (ISS < 15) was conducted. Major trauma patients transported to a TC versus non-tc were further analysed with respect to injured body region and road user type. X STRADA police report X STRADA hospital report Results in short: Our results show that the majority of RTC major trauma patients are transported to a non-trauma centre. This may cause unnecessary morbidity and mortality. These findings can guide the development of improved prehospital treatment guidelines, protocols and decision support systems. Author and organisation: Stefan Candefjord (a,b,c) Ruben Buendia (a,b,c,d) Eva-Corina Caragounise (f) Bengt Arne Sjöqvist (a,b,c) and Helen Fagerlind (b,g,h) a)department of Signals and Systems, Chalmers University of Technology, Gothenburg, Sweden; b)safer Vehicle and Traffic Safety Centre at Chalmers, Gothenburg, Sweden; c) MedTech West, Sahlgrenska University Hospital, Gothenburg, Sweden; d) School of Health Sciences, University of Borås, Borås, Sweden; e) Trauma Unit, Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; f) Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; g) Department of Applied Mechanics, Chalmers University of Technology, Gothenburg, Sweden; h) Neuroscience Research Australia and School of Medical Sciences, University of New SouthWales, Sydney,

Modelling the effect on injuries and fatalities when changing mode of transport from car to bicycle Purpose of the research: Several studies have estimated the health effects of active commuting, where a transport mode shift from car to bicycle reduces risk of mortality and morbidity. Previous studies mainly assess the negative aspects of bicycling by referring to fatalities or police reported injuries. However, most bicycle crashes are not reported by the police and therefore hospital reported data would cover a much higher rate of injuries from bicycle crashes. The aim of the present study was to estimate the effect on injuries and fatalities from traffic crashes when shifting mode of transport from car to bicycle by using hospital reported data. How STRADA was used in the study: The injury and fatality rates for bicyclists and car occupants were given in risk per distance and estimated using data from STRADA. STRADA police report X STRADA hospital report Results in short: The study shows that bicyclists have a much higher injury risk (29 times) and fatality risk (10 times) than car occupants. In a scenario where car occupants in Stockholm living close to their work place shifts transport mode to bicycling, injuries, fatalities and health loss expressed in Disability- Adjusted Life Years (DALY) were estimated to increase. The vast majority of the estimated DALY increase was caused by severe injuries and fatalities and it tends to fluctuate so that the number of severe crashes may exceed the estimation with a large margin. Although the estimated increase of traffic crashes and DALY, a transport mode shift is seen as a way towards a more sustainable society. Thus, this present study highlights the need of strategic preventive measures in order to minimize the negative impacts from increased bicycling. Author and organisation: Philip Nilsson a, Helena Stigson a,b, Maria Ohlin b, c, Johan Strandroth b,d a) Folksam Reasearch, Bohusgatan 14, 10660 Stockholm, Sweden b) Department of Applied Mechanics, Chalmers University of Technology, Hörsalsvägen 7a, 96 Gothenburg, Sweden c) Department of Food and Nutrition and Sport Science, University of Gothenburg, Läroverksgatan 5, 40530 Gothenburg, Sweden d) Swedish Transport Administration, Röda vägen 1, 781 70 Borlänge, Sweden

Cyclist Injuries Leading to Permanent Medical Impairment in Sweden and the Effect of Bicycle Helmets Purpose of the research: Cyclist injuries leading to long term consequences are common and therefore important to identify in order to design a more sustainable road transport system. The aim of this study was to apply impairment scaling to those injuries to reflect long term consequences. Type and location of the crash as well as injury distribution were analyzed. The effect of the bicycle helmet was also calculated using induced exposure techniques. How STRADA was used in the study: The material in this study was Swedish hospital records for the period 2003 2012. STRADA police report X STRADA hospital report Results in short: In total 77% of all bicycle crashes in Sweden were single bicycle crashes, most of which were not police reported. The number of impaired cyclists was more than 3 times larger than those with ISS 9+ (a Injury Severity Score). Of all impairing injuries, almost 70% were to the upper and lower extremities. Furthermore, almost 10% were head injuries. The most common injuries to the upper extremities were to the shoulder and the wrist. Bicycle helmets were found to reduce head impairing injuries by 62%, and severe impairing injuries by 68%. The effectiveness in reducing face injuries was lower (37% and 49%, respectively). Traditional prevention of cyclist injuries has been focused on helmets. However, the findings of the present study indicate a need for other strategies to also prevent other injuries, especially to the upper extremities. Authors: Matteo Rizzi, Helena Stigson, Maria Krafft

Can a Boxer Engine Reduce Leg Injuries Among Motorcyclists? Analysis of Injury Distributions in Crashes Involving Different Motorcycles Fitted with Antilock Brakes (ABS) Purpose of the research: Several studies have shown that motorcycle antilock braking systems (ABS) reduce crashes and injuries. However, it has been suggested that the improved stability provided by ABS would make upright crashes more frequent, thus changing the injury distributions among motorcyclists and increasing the risk of leg injuries. The overall motorcycle design can vary across different categories and manufacturers. For instance, some motorcycles are equipped with boxer-twin engines; that is, with protruding cylinder heads. A previous study based on a limited material has suggested that these could provide some leg protection; therefore, the aim of this research was to analyze injury distributions in crashes involving ABS-equipped motorcycles with boxer-twin engines compared to similar ABS-equipped motorcycles with other engine configurations. How STRADA was used in the study: Swedish hospital and police records from 2003 2014 were used. X STRADA police report X STRADA hospital report Results in short: It was found that the injury types AIS 1+, AIS 2+, and PMI 1+ leg injuries were reduced by approximately 50% among riders with boxer engines. The number of injuries to the upper body did not increase. Conclusions: Boxer-twin engines were not originally developed to improve motorcycle crashworthiness. However, the present article indicates that these engines can reduce leg injuries among riders of motorcycles fitted with ABS. Though it is recommended that future research should look deeper into this particular aspect, the present findings suggest that the concept of integrated leg protection is indeed feasible. Authors: Matteo Rizzi, Folksam

some recommendations are quite obvious Hospital data on road traffic injuries (both short-term and long-term consequences) must be used much more in the future. (OECD; IRTAD; UNDERREPORTING OF ROAD TRAFFIC CASUALTIES, 2007; recommendations) - Data quality can be improved in all countries. In particular, methodologies should be established to compare police collision reports with comparable hospital data and to link these records to improve data quality and consistency (OECD; IRTAD; Road Safety Annual Report 2009; Key recommendations)

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