Fatal and nonfatal accidents on the railways--a study of injuries to individuals, with particular reference to children and to nonfatal trauma.

This paper reports a five-year total population study of fatal railroad accidents involving individuals (that is, not including train crashes or derailments); and a consecutive unselected series of nonfatal isolated injuries in Queensland, Australia. There were 84 fatalities and 211 cases of significant nonfatal traumata. Fatal railway accidents involving children under 15 years of age are now more common in Australia than childhood poisonings and electrocutions. Two syndromes occur--(a) toddlers living near the tracks who simply wander onto the line; and (b) young teenage boys who are run down on level crossings, either as pedestrians or cyclists. Adult fatalities include (a) occupational deaths among railway workers (20%), (b) car-train collisions at level crossings (19%), (c) drunk pedestrians who walk into trains (17%), suicides (12%), and old folk who walk into trains (12%). Of 211 nonfatal cases studied, falls in and from both moving and stationary trains were the most common type of accident. Sudden jolting of the train (probably unpreventable) contributed to 26% of all falls. Twenty-two percent of nonfatal accidents resulted from a person being struck by a train. All persons who survived being struck by a train received serious injuries and required hospital admission. Fatalities involving adults include a high proportion of suicides. Some accidents, such as fingers being caught in windows and doors, can and are being overcome through improved design.