Pedestrian safety: a road safety manual for decision-makers and practitioners <br />Attach <br />Speed management is important for addressing pedestrian safety around the world. <br />Key measures for managing speed include setting speed limits to 30-4o km/h in <br />residential and high pedestrian traffic areas, enforcing traffic rules on speed limits <br />and implementing traffic-calming measures. These measures are examined in detail in <br />Module 4. <br />1.4.2 Alcohol <br />Impairment by alcohol is an important factor influencing both the risk of a road <br />traffic crash as well as the severity and outcome of injuries that result from it (756). <br />Alcohol consumption results in impairment, which increases the likelihood of a <br />crash because it produces poor judgement, increases reaction time, lowers vigilance <br />and decreases visual acuity (56). Alcohol consumption is also associated with exces- <br />sive speed (S7,S8). It is important to note that alcohol impairment as a risk factor is <br />not limited to drivers of vehicles but is also important for pedestrians. Like motor <br />vehicle drivers, a pedestrian's risk of crash involvement increases with increasing <br />blood alcohol content (BAC) (S8). <br />Alcohol impairment and pedestrian injury is a problem in several countries. For <br />example: <br />. Approximately one third of all fatally injured adult pedestrians in Australia have a <br />BAC exceeding o.08 to o.i g/dl (Sp). <br />. Thirty-five per cent of fatally injured pedestrians in the United States in 2.009 had <br />a BAC above o.o8g/dl, compared to 13% of drivers involved in fatal pedestrian <br />crashes (aS). <br />. Data from the United Kingdom show that 46% of fatally injured pedestrians had <br />BAC in excess of o.o9g/dl in 1997 compared with 39% a decade earlier (47). <br />. Twenty per cent of injured pedestrians treated in hospital emergency departments <br />in Eldoret town in Kenya (n=3o) had BAC exceeding the legal limit (i.e. for <br />drivers) of o.o5g/dl (60). <br />. Fifty-nine per cent of pedestrian patients in a hospital in South Africa were <br />impaired above the legal limit of o.o8g/dl (32). Recent data from South Africa <br />indicate that fatally injured pedestrians were more likely than fatally injured <br />drivers to be blood alcohol positive. According to the South African National <br />Injury Mortality Surveillance System, there were 31 177 fatal injuries registered in <br />62. medico-legal laboratories in 2 oo8. Of the 9153 cases that were fatally injured in <br />traffic collisions, BAC values were available in 3o62.(33.5%) of them. Pedestrians <br />had the highest proportion (63%) of those who had positive BAC, followed <br />by drivers (58%), passengers (45%), railway cases (43%) and cyclists (43%) <br />Pedestrians also had the highest mean BAC (o.zi g/dl) - more than four times the <br />legal limit of o.o5g/dl (6z). <br />19 <br />C <br />B <br />64 <br />