The road is a riskier place for pedestrians who need a wheelchair to move around than it is for the average Joe, suggests a recent study published in BMJ Open this November.

Analyzing fatal crashes involving pedestrian wheelchair users from 2006 to 2012, the study authors found that their overall mortality rate via car accident was 36 percent higher than the general population. More particularly, wheelchair-bound men faced a fivefold higher risk than women, and among men aged 50 to 64, they saw a 75 percent increased risk than their similarly-aged but able-bodied counterparts. “Persons who use wheelchairs experience substantial pedestrian mortality disparities, calling for behavioral and built environment interventions,” the authors wrote.

An Increased Risk

The research team relied on two sources of data: the Fatality Analysis Reporting System (FARS), operated by the National Highway Traffic Safety Administration, and an exhaustive scouring of newspaper articles detailing car crashes through LexisNexis. the world’s largest electronic database for public and legal records. This allowed them to not only cross-verify the hits that were found in each source, but also catch any accidents they missed.

Finding an estimated 528 pedestrian wheelchair user fatalities in that time span, they then extrapolated a mortality rate of 2.07 per 100,000 person-years, compared to a 1.52 per 100,000 person-years in the general population. More simply, that means if we were to follow 100,000 pedestrians who use wheelchairs for a full year, we’d expect to see around two car crash-related fatalities during that period. For wheelchair-bound men aged 50 to 64, however, we’d see about 5 fatalities per 100,000 person-years.

While these figures might not seem like a large number, it’s worth remembering that there are (only) 5,000 pedestrian fatalities and another 76,000 injuries annually — and in the latter case, people with wheelchairs are more at risk as well. The researchers also note that their estimates are likely underestimating the true number of fatalities. Perhaps most importantly, however, is that these increased risks are largely preventable through improvements in how we drive and create our roads, according to the authors.

“Some improvements are general to road safety: reducing distracted driving and pedestrian activity, improving safe crossing behaviour, reducing incapacitated driving, and improving pedestrian infrastructure — all of which appear to have played a role in a significant number of fatal crashes identified in this study,” they explained. “Others are specific to pedestrian risks faced by wheelchair users: low conspicuity of the wheelchair and pedestrian infrastructure that is particularly ill-suited to pedestrians who use wheelchairs.”

Apart from making the roads safer for everyone, the changes may give people living with disability a peace of mind sorely needed.

“These findings underscore the need for policymakers and planners to fully incorporate disability accommodations into pedestrian infrastructure and for persons who use wheelchairs—and others with disabilities—to remain a salient population when road safety interventions are designed,” the authors concluded.

Source: Kraemer J, Benton C.Disparities in road crash mortality among pedestrians using wheelchairs in the USA: results of a capture–recapture analysis. BMJ Open. 2015.