Interventions for increasing pedestrian and cyclist visibility for the prevention of death and injuries

  • Review
  • Intervention


  • Irene Kwan,

    Corresponding author
    1. Royal College of Obstetricians & Gynaecologists, National Collaborating Centre For Women's and Children's Health, London, UK
    • Irene Kwan, National Collaborating Centre For Women's and Children's Health, Royal College of Obstetricians & Gynaecologists, 2-16 Goodge Street, London, W1T2QA, UK.

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  • James Mapstone

    1. Castle Point and Rochford NHS Primary Care Trust, Rayleigh, Essex, UK
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Pedestrians and cyclists account for nearly one in three of all road users killed and seriously injured in road traffic crashes. Late detection of other road users is one of the basic driver failures responsible for collisions. Aids to improve pedestrians and cyclist visibility have been used to avert potential collisions. However, the impact of these strategies on drivers' responses, and on pedestrian and cyclist safety is unknown.


1. To quantify the effect of visibility aids versus no visibility aids, and of different visibility aids on the occurrence of pedestrian and cyclist-motor vehicle collisions and injuries.
2. To quantify the effect of visibility aids versus no visibility aids, and of different visibility aids on drivers' detection and recognition responses.

Search methods

Searches were not restricted by date, language or publication status. All electronic databases were searched from date of inception to the most recent date available. We searched CENTRAL (The Cochrane Library 2009, Issue 2), MEDLINE (Ovid SP), TRANSPORT (to 2007/06), PsycINFO (Ovid SP), PsycEXTRA (Ovid SP), ISI Web of Science: Social Sciences Citation Index (SSCI) and ISI Web of Science: Conference Proceedings Citation Index- Science (CPCI-S). We searched the reference lists of included trials, contacted authors and searched the websites of relevant transport research organisations. The searches were last updated in May 2009.

Selection criteria

1. Randomised controlled trials and controlled before-and-after studies of the effect of visibility aids on the occurrence of pedestrian and cyclist-motor collisions and injuries.
2. Randomised controlled trials of the effect of visibility aids on drivers' detection and recognition responses. This included trials where the order of presentation of visibility aids was randomised or balanced using a Latin Square design.

Data collection and analysis

Two authors independently screened records, extracted data and assessed trial quality.

Main results

We found no trials assessing the effect of visibility aids on pedestrian and cyclist-motor vehicle collisions and injuries. To date we have identified 42 trials assessing the effect of visibility aids on drivers' responses. Fluorescent materials in yellow, red and orange colours improve detection and recognition in the daytime. For night-time visibility, lamps, flashing lights and retroreflective materials in red and yellow colours increase detection and recognition. Retroreflective materials enhance recognition, in particular when arranged in a 'biomotion' configuration, taking advantage of the motion from a pedestrian's limbs. Substantial heterogeneity between and within the trials limited the possibility for meta-analysis. Summary statistics and descriptive summaries of the outcomes were presented for individual trials when appropriate.

Authors' conclusions

Visibility aids have the potential to increase visibility and enable drivers to detect pedestrians and cyclists earlier. Biomotion markings, which highlight the movement and form of the pedestrian, showed evidence of improving pedestrians' conspicuity at night. Public acceptability of various effective strategies which improve visibility would merit further development. However, the effect of visibility aids on pedestrian and cyclist safety remains unknown. A cluster randomised controlled trial involving large communities may provide an answer to this question. It would, however, be a challenging trial to conduct. Studies that collect data of road traffic injuries relating to the use of visibility aids also warrant consideration.








我們搜尋了CENTRAL,Cochrane Injuries Group's specialised register, MEDLINE, TRANSPORT, National Research Register, PsycInfo及PsycLit。我們搜尋了所納入的試驗的參考文獻清單,我們聯絡了作者並且搜尋了相關的交通運輸研究機構的網站。最後一次搜尋的更新是在2005年4月。






我們發現沒有評估能見度輔助設備對於行人及自行車騎士與機動車碰撞和受傷發生效果的試驗。我們找到了39篇評估能見度輔助設備對於駕駛者反應效果的試驗。在白天,黃色、紅色和橘色的螢光物質能增進察覺和辨認反應。對於夜間的能見度,紅色和黃色的燈具、閃光燈和回復反射物體能夠增加察覺度和辨認反應度。處於‘biomotion’型態下的回復反射物體也能夠增加辨認度。試驗與試驗間以及各試驗內部實質存在的異質性妨礙了統合分析的可能性。在合宜的情況下,我們也呈現了各試驗的總結統計量(Summary statistics)和描述性結果的總結。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Increasing pedestrian and cyclist visibility to prevent deaths and injuries

Pedestrians and cyclists are often killed or seriously injured in traffic crashes, especially in developing countries where walking and bicycling are essential modes of transportation. In the UK, one in three road traffic fatalities is a pedestrian or cyclist. Usually, in these crashes drivers fail to see the pedestrian or cyclist until it is too late. In recent years reflective garments, flashing lights, and other visibility aids have been used to try to prevent crashes.

The authors of this Cochrane review looked for studies which showed how effective visibility aids are for protecting pedestrians and cyclists. They focused their search on a type of study called a randomised controlled trial, which compares two similar groups of people who only differ on the issue being studied, for instance, the rate of crashes in communities with and without introduction of visibility aids. The authors found no studies that compared number of crashes but to date they have found 42 studies which compare driver detection of people with or without visibility aids. These studies showed that fluorescent materials in yellow, red and orange improved driver detection during the day; while lamps, flashing lights and retroreflective materials in red and yellow, particularly those with a 'biomotion' configuration (taking advantage of the motion from a pedestrian's limbs), improved pedestrian recognition at night. Although these visibility measures help drivers see pedestrians and cyclists, more research should be done to determine whether the increased visibility actually does prevent deaths and serious injuries.

Laienverständliche Zusammenfassung

Verbesserung der Sichtbarkeit von Fußgängern und Radfahrern zur Vorbeugung von Verletzungen und Tod

Fußgänger oder Radfahrer werden in Verkehrsunfällen oft schwer oder sogar tödlich verletzt, insbesondere in Entwicklungsländern, wo Gehen und Radfahren wichtige Fortbewegungsmethoden sind. In Großbritannien sind in einem von drei Verkehrsunfällen Fußgänger oder Radfahrer verwickelt. Eine der häufigsten Ursachen für diese Unfälle ist, dass Fußgänger und Fahrradfahrer zu spät von den Autofahrern gesehen werden. Maßnahmen wie reflektierende Kleidung rote und gelbe Blinklichter und andere Hilfen zur besseren Sichtbarkeit, wurden verwendet, um Unfälle vorzubeugen.

Die Autoren dieser Übersichtsarbeit suchten nach Studien die die Wirksamkeit dieser Maßnahmen zur erhöhten Sichtbarkeit überprüft haben. In ihrer Suche wurden randomisierte, kontrollierte Studien, fokussiert die zwei Gruppen miteinander vergleichen, zum Beispiel die Unfallrate in Gemeinden mit und ohne Maßnahmen zur erhöhten Sichtbarkeit. Es wurde keine Studie zur Anzahl der Unfälle gefunden, aber 42 Studien, die verglichen, ob Autofahrer Menschen mit oder ohne Maßnahmen zur erhöhten Sichtbarkeit besser sehen. Diese Studien zeigten, dass fluoreszierende Materialien in gelb, rot und orange die Sichtbarkeit am Tag verbessern, während Lampen, blinkende Lichter und reflektierende Materialien in rot und gelb, insbesondere solche mit einer "BioMotion"-Konfiguration (unter Ausnutzung der Bewegung von Gliedmaßen eines Fußgängers), die Sichtbarkeit in der Nacht verbessern. Obwohl diese Maßnahmen dazu beitragen, die Sichtbarkeit von Fußgängern und Radfahrern zu erhöhen, sollten weitere Studien durchgeführt werden, um festzustellen, ob die erhöhte Sichtbarkeit tatsächlich schwere Verletzungen und Tod vorbeugen kann.

Anmerkungen zur Übersetzung

Koordination durch Cochrane Schweiz.