Ramp-Related Incidents Involving Wheeled Mobility Device Users During Transit Bus Boarding/Alighting

• Public transportation is important for integrating wheelchair users in the community.
• Physicians need to be aware of conditions wheelchair users encounter when accessing transit buses.
• Knowledge of ramp slope conditions may better inform wheelchair prescriptions for transit riders.
• Skills training should accompany wheelchair prescriptions for the development of transit skills.

ObjectivesTo estimate the prevalence of wheeled mobility device (WhMD) ramp-related incidents while boarding/alighting a public transit bus and to determine whether the frequency of incidents is less when the ramp slope meets the proposed Americans with Disabilities Act (ADA) maximum allowable limit of ≤9.5°.DesignObservational study.SettingCommunity public transportation.ParticipantsWhMD users (N=414) accessing a public transit bus equipped with an instrumented ramp.InterventionsNot applicable.Main Outcome MeasuresPrevalence of boarding/alighting incidents involving WhMD users and associated ramp slopes; factors affecting incidents.ResultsA total of 4.6% (n=35) of WhMD users experienced an incident while boarding/alighting a transit bus. Significantly more incidents occurred during boarding (6.3%, n=26) than during alighting (2.2%, n=9) (P<.01), and when the ramp was deployed to street level (mean slope=11.4°) compared with sidewalk level (mean slope=4.2°) (P=.01). The odds ratio for experiencing an incident when the ramp slope exceeded the proposed ADA maximum allowable ramp slope was 5.4 (95% confidence interval, 2.4–12.2; P<.01). The odds ratio for assistance being rendered to board/alight when the ramp slope exceeded the proposed ADA maximum allowable ramp slope was 5.1 (95% confidence interval, 2.9–9.0; P<.01).ConclusionsThe findings of this study support the proposed ADA maximum allowable ramp slope of 9.5°. Ramp slopes >9.5° and ramps deployed to street level are associated with a higher frequency of incidents and provision of assistance. Transit agencies should increase awareness among bus operators of the effect kneeling and deployment location (street/sidewalk) have on the ramp slope. In addition, ramp components and the built environment may contribute to incidents. When prescribing WhMDs, skills training must include ascending/descending ramps at slopes encountered during boarding/alighting to ensure safe and independent access to public transit buses.