The relationship between impact speed and the probability of pedestrian fatality during a vehicle-pedestrian crash: A systematic review and meta-analysis.

BACKGROUND

Pedestrians struck in motorised vehicle crashes constitute the largest group of traffic fatalities worldwide. Excessive speed is the primary contributory factor in such crashes. The relationship between estimated impact speed and the risk of a pedestrian fatality has generated much debate concerning what should be a safe maximum speed limit for vehicles in high pedestrian active areas.

METHODS

Four electronic databases (MEDLINE, EMBASE, COMPENDEX, and SCOPUS) were searched to identify relevant studies. Records were assessed, and data retrieved independently by two authors in adherence with the PRISMA statement. The included studies reported data on pedestrian fatalities from motorised vehicle crashes with known estimated impact speed. Summary odds ratios (OR) were obtained using meta-regression models. Time trends and publication bias were assessed.

RESULTS

Fifty-five studies were identified for a full-text assessment, 27 met inclusion criteria, and 20 were included in a meta-analysis. The analyses found that when the estimated impact speed increases by 1 km/h, the odds of a pedestrian fatality increases on average by 11% (OR = 1.11, 95% CI: 1.10-1.12). The risk of a fatality reaches 5% at an estimated impact speed of 30 km/h, 10% at 37 km/h, 50% at 59 km/h, 75% at 69 km/h and 90% at 80 km/h. Evidence of publication bias and time trend bias among included studies were found.

CONCLUSIONS

The results of the meta-analysis support setting speed limits of 30-40 km/h for high pedestrian active areas. These speed limits are commonly used by best practice countries that have the lowest road fatality rates and that practice a Safe System Approach to road safety.