Health loss after road transport injury – new perspectives

Abstract Background Health loss in the road transport system is a major public health problem. Globally, about a fifth of all fatalities within the road transport system are represented by pedestrians, and bicyclists are the group with the highest number of severe injuries in the EU. Here we strive to add new perspectives of health loss in different road user groups examining sickness absence (SA) and disability pension (DP) and in the case of injuries after car crashes also relating them to permanent medical impairment (PMI). Methods Several register-based studies were conducted, based on microdata linked at individual level from several Swedish nationwide registers. In one study information about PMI from the insurance company Folksam was also used. In the main analyses we included all working individuals aged 20-59 years injured in a road traffic accident (pedestrians, bicyclists, car occupants, and other road users) in 2015 in Sweden and population-based matched references without any traffic-related injury. Diagnosis specific SA and DP were assessed during 1 year before and 4 years following the accident. Results A third of the traffic-related accidents involved bicyclists, 31% car occupants, 16% pedestrian, and 19% were other accidents. The excess SA days/year was elevated for all road user groups the whole study period. Excess SA due to injury diagnoses was 15-35 days/year during the first year following the accident. Among individuals injured in a car crash that reported the injury to Folksam, 2% had a new DP 2 years after the crash, and 8% had injuries resulting in PMI. A distinct trend showed that the proportion granted DP increased with increasing PMI grade. Conclusions Sickness absence is a common outcome among individuals injured in the road transport system. Together, these studies highlight the importance of preventing not only fatalities in the road transport system but also non-fatal injuries.