This paper examines pedestrian anatomical injuries and crash characteristics in back-to-traffic and facing-traffic crashes. Pedestrian crashes involving pedestrians walking along streets (i.e. with their backs to traffic or facing traffic) have been overlooked in literature. Although this is not the most frequent type of crash, the crash consequence to pedestrians is a safety concern. Combining Taiwan A1A2 police-reported accident data and data from the National Health Insurance Database from years 2003–2013, this paper examines anatomical injuries and crash characteristics in back-to-traffic and facing-traffic crashes. There were a total of 830 and 2267 pedestrian casualties in back-to-traffic and facing-traffic crashes respectively. The injuries sustained by pedestrians and crash characteristics of these two crash types were compared with those of other crossing types of crashes (nearside crash, nearside dart-out crash, offside crash, and offside dart-out crash). Odds of various injuries to body regions were estimated using logistic regressions. Key findings include that the percentage of fatalities in back-to-traffic crashes is the highest; logistic models reveal that pedestrians in back-to-traffic crashes sustained more head, neck, and spinal injuries than did pedestrians in other crash types, and unlit darkness and non-built-up roadways were associated with an increased risk of pedestrian head injuries. Several crash features (e.g. unlit darkness, overtaking manoeuvres, phone use by pedestrians and drivers, and intoxicated drivers) are more frequently evident in back-to-traffic crashes than in other types of crashes. The current research suggests that in terms of crash consequence, facing traffic is safer than back to traffic.
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