Analysis of injuries to young and old Victorian public transport users: 2006-2010

A study was undertaken to identify injurious events to users of public transport systems in Australia to assist in the UK project on Improving the Safety for Older Public Transport Users. Two analyses were undertaken comprising an analysis of surveillance data (the Victorian Emergency Minimum Dataset), collected at a number of participating trauma hospitals in the state of Victoria, and an analysis of National Coronial Information System (NCIS) data in Australia. For the VEMD database, details of injuries were recorded on attendance and the patients’ account of the circumstances of the accident and causation factors were noted. Data from the NCIS involved a collection of coronial data on deaths reported to the Australian coroner from 2000 onwards and contains details on the police report of death, autopsy reports, toxicology reports and coronial findings. The VEMD results showed that injury was more common among bus passengers than those on either trams or trains, especially when taking account of their relatively lower usage. The most common injuries from these incidents were to the head and face regions and upper and lower limbs. Chest injuries were especially problematic for older travellers: they sustained more multiple injuries especially those likely to be life-threatening than their younger counterparts. Getting on or off the vehicle accounted for almost two-thirds of all injury-causing events and the most common mechanisms involved a slip, trip or fall while getting on and off the vehicle or while onboard or running to catch public transport. Being hit, struck or crushed by another person or an object was also reported. Injuries to older public transport users appeared to be positively correlated with increasing age. The majority of those injured only required out-patient treatment at the participating hospital but this too was somewhat dependent on the participant’s age. The NCIS results further showed that for fatal outcomes to public transport users, self-harm was a predominant cause and older people seemed less involved than younger ones, albeit young-older groups. Males predominated over females and most mechanisms involved external impacts. Trains were heavily over-involved as a vehicle type and there were high proportions of multiple injuries, especially those judged to be intentional. A range of possible interventions to prevent these events and mitigate injury severity was identified and a number of limitations in this study were noted. Several areas requiring further research were identified for future studies, in particular, the need for more definitive in-depth studies of public transport injurious incidents was especially noteworthy.