Moran Dane, Bose Dipan, Bhalla Kavi
a Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland.
b World Bank Global Road Safety Facility , Washington, D.C.
Traffic Inj Prev. 2017 Nov 17;18(8):832-838. doi: 10.1080/15389588.2017.1324200. Epub 2017 May 1.
European car design regulations and New Car Assessment Program (NCAP) ratings have led to reductions in pedestrian injuries. The aim of this study was to evaluate the impact of improving vehicle front design on mortality and morbidity due to pedestrian injuries in a European country (Germany) and 2 countries (the United States and India) that do not have pedestrian-focused NCAP testing or design regulations.
We used data from the International Road Traffic and Accident Database and the Global Burden of Disease project to estimate baseline pedestrian deaths and nonfatal injuries in each country in 2013. The effect of improved passenger car star ratings on probability of pedestrian injury was based on recent evaluations of pedestrian crash data from Germany. The effect of improved heavy motor vehicle (HMV) front end design on pedestrian injuries was based on estimates reported by simulation studies. We used burden of disease methods to estimate population health loss by combining the burden of morbidity and mortality in disability-adjusted life years (DALYs) lost.
Extrapolating from evaluations in Germany suggests that improving front end design of cars can potentially reduce the burden of pedestrian injuries due to cars by up to 24% in the United States and 41% in India. In Germany, where cars comply with the United Nations regulation on pedestrian safety, additional improvements would have led to a 1% reduction. Similarly, improved HMV design would reduce DALYs lost by pedestrian victims hit by HMVs by 20% in each country. Overall, improved vehicle design would reduce DALYs lost to road traffic injuries (RTIs) by 0.8% in Germany, 4.1% in the United States, and 6.7% in India.
Recent evaluations show a strong correlation between Euro NCAP pedestrian scores and real-life pedestrian injuries, suggesting that improved car front end design in Europe has led to substantial reductions in pedestrian injuries. Although the United States has fewer pedestrian crashes, it would nevertheless benefit substantially by adopting similar regulations and instituting pedestrian NCAP testing. The maximum benefit would be realized in low- and middle-income countries like India that have a high proportion of pedestrian crashes. Though crash avoidance technologies are being developed to protect pedestrians, supplemental protection through design regulations may significantly improve injury countermeasures for vulnerable road users.
欧洲汽车设计法规和新车评估计划（NCAP）评级已使行人受伤情况有所减少。本研究的目的是评估改进车辆前端设计对一个欧洲国家（德国）以及两个没有以行人为重点的NCAP测试或设计法规的国家（美国和印度）中行人受伤导致的死亡率和发病率的影响。
我们使用了国际道路交通和事故数据库以及全球疾病负担项目的数据来估计2013年每个国家的基线行人死亡和非致命伤害情况。乘用车星级评定改善对行人受伤概率的影响基于德国近期对行人碰撞数据的评估。重型机动车（HMV）前端设计改进对行人受伤的影响基于模拟研究报告的估计值。我们使用疾病负担方法，通过将发病率和死亡率负担合并为伤残调整生命年（DALYs）损失来估计人群健康损失。
根据德国的评估推断，改进汽车前端设计可能会使美国因汽车导致的行人受伤负担最多降低24%，印度降低41%。在德国，汽车符合联合国行人安全法规，进一步改进将导致负担降低1%。同样，改进HMV设计将使每个国家中被HMV撞到的行人受害者的DALYs损失减少20%。总体而言，改进车辆设计将使德国道路交通伤害（RTIs）导致的DALYs损失降低0.8%，美国降低4.1%，印度降低6.7%。
近期评估表明，欧洲NCAP行人得分与现实生活中的行人受伤情况之间存在很强的相关性，这表明欧洲汽车前端设计的改进已导致行人受伤情况大幅减少。尽管美国的行人碰撞事故较少，但采用类似法规并开展行人NCAP测试仍将使其大幅受益。最大的好处将在像印度这样行人碰撞事故比例很高的低收入和中等收入国家实现。尽管正在开发防撞技术以保护行人，但通过设计法规提供的补充保护可能会显著改善对弱势道路使用者的伤害应对措施。
