Crossing the road can be challenging and more dangerous for wheelchair users.
Nearly 5,000 pedestrians are killed every year and another 76,000 are injured in road traffic collisions on public roads in the US.
The risk of death among pedestrian wheelchair users compared with that of the general population has not been studied before.
Researchers examined the overlap between two independent but incomplete data sources to estimate the total number of pedestrian deaths caused by car crashes from 2006-12.
The research technique used is called two-source capture-recapture.
The two sources used were national news stories on car crash fatalities published on the LexisNexis US newspaper database and the National Highway Traffic Safety Administration's Fatality Analysis Reporting System (FARS), based on police reports of road traffic collisions on roads in the US.
According to the report, fatalities counted were of individuals who were "non-vehicle occupants" and "restricted to a wheelchair" or "a motorized wheelchair rider and one of the following non-occupant types: pedestrian, non-motor vehicle transport device occupant or person using a personal conveyance."
The news registry included 107 fatal crashes involving pedestrians using wheelchairs, and the FARS registry included 185. Of these, 37 were included in both registries, yielding an estimated 528 fatalities in total from 2006-12.
One-third higher risk for wheelchair users
Findings indicate a 30% higher risk of death for a pedestrian wheelchair user than for pedestrians in general.
The risk of a car crash death would appear to be over five times higher for men in wheelchairs than for women, particularly among the 50-64 age group.
Almost half of the fatal crashes, or 47.6%, happened at intersections, at 39% of which there was no traffic flow control.
Among intersection crashes, 47.5% involved wheelchair users in a crosswalk; no crosswalk was available in 18.3% of cases. Drivers failed to yield right-of-way in 21.4% of crashes, and no crash avoidance maneuvers were detected in 76.4% of incidents.
Police reports also indicated that the wheelchair user was not sufficiently visible in 15% of the incidents.
The true number of deaths is likely to be higher than this because mobility devices were not always differentiated from recreational scooters and mopeds in news stories.
Need for behavioral and environmental changes
The team raises the issue of inadequate pedestrian facilities, noting that "persons who use wheelchairs experience substantial pedestrian mortality disparities calling for behavioral and built environment interventions."
They stress the importance of well-designed curb cuts, ramps and sidewalks to enable people who use wheelchairs to safely traverse roads; in fact, these are often required by the Americans with Disabilities Act.
The authors conclude:
"[Our] findings underscore the need for policy-makers and planners to fully incorporate disability accommodations into pedestrian infrastructure and for persons who use wheelchairs and others with disabilities to remain a salient population when road safety interventions are designed."
Medical News Today reported earlier this year that sleep apnea in drivers increases the risk of road traffic accidents.