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The incidence of pelvic and lower extremity fractures is examined by reference to data extracted from police and hospital records. It is shown that the incidence and number of fractures to the pelvis and the lower extremities is strongly dependent on the age of the struck pedestrian and the speed of the vehicle. Pelvic injuries are shown to be more common in elderly females than in other age groups and it is suggested that this is due to elderly females being more likely, with current vehicle front end heights, to sustain a direct blow at the level of the pelvis. Pubic rami fractures appear to result when there are distributed impact forces at the level of the pelvis and acetabular fractures occur when there are concentrated forces applied to the greater trochanter.

The relative importance of child pedestrian accidents is first considered by reference to national accident statistics for Great Britain. Data from a study using existing hospital and police records are then used to examine the location of the initial pedestrian contacts with the vehicle and the effects of initial contact on overall injury severity. In particular the incidence of ‘run over’ accidents is examined and it is shown that, contrary to popular belief, the very young child is rarely run over by the striking vehicle. The injuries sustained by child pedestrians struck by the fronts of cars or light goods vehicles derived from a car are then described and the differences in injury patterns with age examined. The effects of vehicle front end height on the injuries sustained are considered and it is shown that when the front end height is 0.6 - 0.7 pedestrian height there is an increased risk of neck injury compared to other relative front end heights.

The relative importance of pedestrian accidents as a source of road accident trauma is shown by reference to national and international data. The methodology of pedestrian accident investigation at Birmingham University is presented and the results of a recent study used to describe the general characteristics of pedestrian accidents. The pattern of injury sustained by pedestrians struck by the fronts of cars is described and the nature, cause and severity of leg injuries and head injuries considered in detail. The implications of bumper location are discussed. The importance of the windscreen frame as a source of serious head trauma is demonstrated.

The evolution of in-depth research studies in Europe is reviewed, with particular emphasis on work in Britain since the early 1960's. The catalytic role of the NATO-CCMS programme in establishing in-depth teams in a number of countries and in developing common methodologies, notably in crash and injury severity, is outlined. The methodology of in-depth studies currently being conducted at the Accident Research Units at Birmingham University and at the Institute for Consumer Ergonomics at Loughborough is outlined and some observations are made on data collection techniques, analysis and project management.

Some of the factors influencing the introduction of mandatory seatbelt use in Great Britain are outlined. The effectiveness of seatbelts is considered. Pre- and postlaw seatbelt use rates are described. The reductions in frontseat car occupant casualties following the introduction of the law are reported, and it is noted the actual reduction in fatalities is in line with the expected reduction. The results of the time series analyses of all road accident casualties are presented. These analyses indicate, with the data currently available, the changes in the numbers of other road users injured and killed cannot be attributed to the effects of the seatbelt legislation but are in line with normal seasonal and annual fluctuations. A brief review is made of studies relevant to the debate on risk compensation, and it is concluded that available evidence indicates that risk compensation probably does not occur when drivers are compelled to wear seatbelts.

A brief review of pedestrian injury research in Europe is made. The circumstances of pedestrian accidents are described and particular attention is given to the location of the pedestrian's initial contact with the vehicle exterior and to the speed of the vehicle at impact. The dynamics of pedestrian impact are described. Some data on the pattern of pedestrian injury is presented and the general cause of pedestrian injury considered. The influence of bumper height, bonnet height, bumper lead and front structure compliance on pelvic and leg injuries is considered. The influence of vehicle design on vehicle contact head injuries is examined. Consideration is given to the likely benefits to pedestrians that could accrue from changes in vehicle exterior design.