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An editorial in next Saturday's issue of the BMJ points out that the risk of fatality when an SUV collides with a pedestrian is nearly twice that of a similar event involving a passenger car.
The reason for this is not the SUV's larger size and mass, but its higher bonnet, it says.
When a passenger car hits a pedestrian, its bumper typically strikes the legs, the leading edge of the bonnet then hits the femur or pelvis and the pedestrian then folds downward, hitting the bonnet or windscreen.
This so-called "wrap and carry" movement means that a lot of the energy of impact is likely to be transferred to the more pliable steel of the bonnet.
In addition, the key organs of the upper body are less likely to get directly hit.
Specific dangers for young children
But with an SUV, there is no folding movement - the high, blunt front end of the vehicle wacks straight into the vital organs, doubling the injuries to vulnerable regions as the head, thorax and abdomen.
The editorial says the rise in SUV sales in many countries is especially dangerous to older people, who account for an ever-growing part of the population.
These vehicles also hold out specific dangers for young children when the driver is reversing, and cannot see out of the high back window.
The article calls for governments to do more to investigate the role of SUVs in accidents involving pedestrians.
'Resistance from the industry'
And, it says, vehicle manufacturers and distributors should display warning notices on SUVs to "advise potential purchasers of the increased risk of severe injury and death to pedestrians associated with this vehicles."
It admits, though: "Resistance from the industry to such initiatives is likely to be strong, just as it has been from the tobacco industry for warnings on cigarettes."
The editorial is penned by Desmond O'Neill, an associate professor of medical gerontology, and Ciaran Simms, a lecturer in mechanical engineering, both at Trinity College, Dublin.
In Europe, sales of SUVs have increased by 15% in the past year, while sales of standard cars have dropped by four percent, according to figures they cited.
In the United States, 40% of new vehicles are officially categorised as light trucks or vans, many of which are SUVs.
Pedestrians account for about 20% of road casualties in the European Union (EU), but rise to nearly 50% in poor countries, where roads are worse and more people travel on foot.
