866 Epidemiology and mapping of road traffic collisions with child casualties in wales

Abstract

<h3>Background</h3> Road traffic collisions (RTCs) are one of the leading causes of childhood morbidity and mortality, representing a significant public health burden. Children, being smaller and less visible to traffic, are at greater risk of severe consequences of RTCs. Data from the electronic reporting system used by the police, known as STATS19, informs national road safety policies in Wales. <h3>Objectives</h3> This project aimed to establish whether the number of children injured due to RTCs in Wales is under-represented in STATS19. We did this by comparing data from a Major Trauma Centre (MTC) in South Wales to STATS19. In addition, we characterised RTCs with child casualties and mapped the geographical distribution with the objective of identifying clusters and to ascertain if more injuries occurred in deprived areas using the Welsh Index of Multiple Deprivation. <h3>Methods</h3> We analysed data from STATS19, the Emergency Medical Retrieval and Transfer Service (EMRTS) and a MTC from 2017–2019 for child pedestrians, cyclists and car occupants aged 0–16 years injured following RTCs. We studied age, gender, the time of RTC occurrence, the road type, speed limit and presence of crossing facilities. Population-based injury rates for each year were calculated for age group, gender and deprivation fifth. The geographical distribution of RTCs was mapped using QGIS 3.16. <h3>Results</h3> We found that STATS19 under-reported paediatric trauma due to RTCs. From 2017–2019 STATS19 recorded 1,859 child casualties across all of Wales compared to 1,170 local child RTC attendances at one MTC. Given the distribution of the Welsh population and the availability of emergency departments throughout the country, it is unlikely that 62.9% of all paediatric trauma following RTCs came to one MTC. Males aged 11–16 years had the highest rates of injury at 92.2 per 100,000 population, compared with females aged 1–4 years which had the lowest rates of injury at 26.2 per 100,000 population. Injuries peaked at school journey times and were highest between 2pm-5pm (45.1% in STATS19, 63.5% in EMRTS and 35.2% at one MTC). Most RTCs were located on single carriageways (84.7%), in 30 mph zones (66.9%), between junctions (54.1%) and with no pedestrian crossing within 50 metres (85.0%). The rate ratio of injury was 2.03 (95% confidence interval 1.72–2.38) significantly higher for the most deprived areas compared to the least deprived areas. <h3>Conclusions</h3> Emergency departments play an important role in recording child casualties due to RTCs. Our findings reveal the large scale of data that the Welsh Government could be missing. Without this knowledge we are failing to see the whole picture and cannot accurately characterise risks to road users. Collaboration between services and improvements in data quality are needed to inform national public health policy in order to reduce the incidence of child casualties following RTCs. Road safety schemes should be prioritised in the most deprived areas where the burden of injury due to RTCs is highest, which will help to lessen the social inequality gap.