Although the national road accident records collected by the police provide valuable information on the number and circumstances of road accidents, they lack any significant detail on the nature and severity of injury to the casualties involved. There is also evidence that for some road users, notably cyclists, a substantial proportion of the accidents are not reported to the police. In order to assess the severity of injuries on a clinical basis and the degree of underreporting, an in-depth hospital based study was undertaken. The study reported collected information on road accident casualties, presenting to hospital, for the whole of Oxfordshire for 1983 and 1984. Amongst the principal conclusions it was found that young people between 16 and 25 years of age were particularly susceptible to being injured in road accidents. Rear seat passengers of cars (if unbelted) had a very significantly greater chance of being ejected, and thereby being severely injured, than front seat occupants. The proportion of injury accidents reported to the police was particularly low for pedal cyclists and motor cyclists where no other vehicle was involved. Car drivers received significantly more injuries to the face and arms than equivalent front seat passengers. Pedestrian casualties had an increased likelihood of death and serious injury over other groups. For non-minor injuries, nearly one third of casualties sustained some degree of long term disability (at 1 year) and nearly one quarter had not returned to work after this time. Disabilities were over-represented in those with injuries to the lower limbs and those with 'whiplash' injuries. Attention is drawn to the implications of these findings and requirements for further research are suggested.

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