A 20-Year Review of Recumbent Pedestrian Fatalities (2001-2020).

A retrospective study was performed in the Northern Territory of Australia of all cases of pedestrian fatalities where the decedents had been sitting, crouching, sleeping, or lying on or next to a road, over a 20-year period (January 1, 2001 to December 31, 2020). Of the 865 road traffic fatalities, 161 (19%) were pedestrians, and 42 of these were recumbent at the time of the incident (26% of all pedestrians). The most common age range was 30 to 39 years with a male to female ratio of 25:17. No individuals younger than 15 years were involved. Acute alcohol intoxication played a role in death in all of the cases with medium to high range blood alcohol concentrations. In addition, cannabis or its metabolites were detected in 6 cases, and methylamphetamine in 1 case. A history of chronic alcohol use or dependence was known in 6 (14%) of cases. In no case was an underlying medical condition contributory to death. The majority of incidents occurred at night. This study has shown a very high incidence of recumbent pedestrian deaths in an Australian subpopulation related to acute alcohol intoxication, decreased visibility, and vulnerability because of their position on or proximate to a road.