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.