Child Pedestrian Motor Vehicle Collisions Research Articles

Social inequalities in child pedestrian collisions: The role of the built environment

Important inequities in child pedestrian-motor vehicle collisions (PMVC) have been observed. The mechanism through which social dimensions influence child PMVC is not well understood, nor is the role of the roadway-built environment. The relationship between area-level social dimensions (material deprivation, proportion recent immigrants, proportion visible minority) and police-reported child PMVC between 2010 and 2018 in Toronto, Canada was examined using multivariable negative binomial regression models, controlling for built environment covariates. All social dimensions were significantly associated with child PMVC, including material deprivation (Incidence Rate Ratio (IRR –adjusted ): 1.31, 95 % Confidence Interval (CI): 1.22–1.40), recent immigrant proportion (IRR adjusted : 1.58, 95 %CI: 1.30–1.92, per 10 % increase), and visible minority proportion (IRR adjusted : 1.09, 95 %CI: 1.05–1.12, per 10 % increase). Built environment features did not attenuate these associations. This study provides evidence of social inequalities in child PMVC, suggesting a need to target traffic safety interventions towards the most socially marginalized areas.

Driver and road characteristics associated with child pedestrian injuries

BackgroundChild pedestrians make up a significant proportion of all road traffic deaths. Our primary objective was to examine the association of driver characteristics with child pedestrian injuries with a secondary objective to broadly describe the road characteristics surrounding these collisions. MethodsWe included drivers involved in child (<18 years old) pedestrian motor-vehicle collisions (PMVCs) in Calgary and Edmonton, Alberta (2010–2015). These drivers were compared with not at fault (Alberta adaptation of a Canadian culpability scoring tool) drivers involved in vehicle-only collisions. The data were analyzed with unconditional logistic regression. ResultsSeven hundred ninety-three drivers collided with 826 children. One quarter of child PMVC drivers were 40–54 years old (25.2%). Younger drivers, 16–24 (adjusted odds ratio [aOR] = 1.62, 95% CI: 1.27–2.09), and older drivers, ≥55 (aOR = 1.57, 95% CI: 1.24–1.99) were more likely to be involved in a child PMVC. Time of day between 06:01 – 09:00 (aOR = 1.46, 95% CI: 1.16–1.85) and 18:01 – 24:00 (aOR = 1.68, 95% CI: 1.30–2.17), no seatbelt use (aOR = 2.30, 95% CI: 1.09–4.85), having a child passenger in the vehicle (aOR = 2.15, 95% CI: 1.56–2.96), and impairment including ‘had been drinking’ (aOR = 7.70, 95% CI: 2.85–20.86) and ‘fatigued/asleep/medical defect’ (aOR = 27.15, 95% CI: 8.30–88.88) were also associated with being a driver involved in a child PMVC. ConclusionsAge, time, impairment and distraction were risk factors for being a driver involved in a child PMVC. Because child PMVC driver characteristics differ from the general driver population, driver-based interventions are a rational additional means of preventing child PMVCs.

Spatial distribution of roadway environment features related to child pedestrian safety by census tract income in Toronto, Canada

BackgroundInvestments in traffic calming infrastructure and other street design features can enhance pedestrian safety as well as contribute to the ‘walkability’ of neighbourhoods. Pedestrian–motor vehicle collisions (PMVCs) in urban areas,...

School environments and social risk factors for child pedestrian-motor vehicle collisions: A case-control study

BackgroundChild pedestrian-motor vehicle collisions (PMVCs) have decreased in Canada in the past 20 years. Many believe this trend is explained by the rise in automobile use for all travel. Initiatives to increase walking to school need to consider PMVC risk. Potential risk factors related to walking to school, the built environment and social factors were examined for schools with historically high child PMVC rates. MethodsChild PMVCs (age 4–12 years) from 2000 to 2013 and built environment features were mapped within school attendance boundaries in the City of Toronto, Canada. Case and control schools were in the highest and lowest PMVC quartiles respectively. Observational counts of travel mode to school were conducted. Logistic regression evaluated walking to school, built environment and social risk factors for higher PMVC rates, stratified by geographic location (downtown vs. inner suburbs). ResultsThe mean PMVC rates were 18.8/10,000/year (cases) and 2.5/10,000/year (controls). One-way street density (OR=4.00), school crossing guard presence (OR=3.65) and higher social disadvantage (OR=1.37) were associated with higher PMVCs. Higher residential land use density had a protective effect (OR=0.56). More walking was not a risk factor. While several built environment risk factors were identified for the inner suburbs; only social disadvantage was a risk factor within older urban neighbourhoods. ConclusionsSeveral modifiable environmental risk factors were identified for child PMVCs. More walking to school was not associated with increased PMVCs after controlling for the environment. School social disadvantage was associated with higher PMVCs with differences by geographic location. These results have important implications for the design of roadways around schools.

Dangerous student car drop-off behaviors and child pedestrian–motor vehicle collisions: An observational study

Objectives: The objective of this study was to examine the association between dangerous student car drop-off behaviors and historical child pedestrian–motor vehicle collisions (PMVCs) near elementary schools in Toronto, Canada.Methods: Police-reported child PMVCs during school travel times from 2000 to 2011 were mapped within 200 m of 118 elementary schools. Observers measured dangerous student morning car drop-off behaviors and number of children walking to school during one day in 2011. A composite score of school social disadvantage was obtained from the Toronto District School Board. Built environment and traffic features were mapped and included as covariates. A multivariate Poisson regression was used to model the rates of PMVC/number of children walking and dangerous student car drop-off behaviors, adjusting for the built environment and social disadvantage.Results: There were 45 child PMVCs, with 29 (64%) sustaining minor injuries resulting in emergency department visits. The mean collision rate was 2.9/10,000 children walking/year (SD = 6.7). Dangerous drop-off behaviors were observed in 104 schools (88%). In the multivariate analysis, each additional dangerous drop-off behavior was associated with a 45% increase in collision rates (incident rate ratio [IRR] = 1.45, 95% confidence interval [CI], 1.02, 2.07). Higher speed roads (IRR = 1.27, 95% CI, 1.13, 1.44) and social disadvantage (IRR = 2.99, 95% CI, 1.03, 8.68) were associated with higher collision rates.Conclusions: Dangerous student car drop-off behaviors were associated with historical nonfatal child PMVC rates during school travel times near schools. Some caution must be taken in interpreting these results due small number of events and limitations in the data collection, because collision data were collected historically over a 12-year period, whereas driving behavior was only observed on a single day in 2011. Targeted multifaceted intervention approaches related to the built environment, enforcement, and education could address dangerous drop-off behaviors near schools to reduce child PMVCs and promote safe walking to school.

Driving behaviours near schools and child pedestrian-motor vehicle collisions in Toronto, Canada

Driving behaviours near schools and child pedestrian-motor vehicle collisions in Toronto, Canada

Do school crossing guards make crossing roads safer? A quasi-experimental study of pedestrian-motor vehicle collisions in Toronto, Canada.

BackgroundThe presence of school crossing guards has been associated with more walking and more pedestrian-motor vehicle collisions (PMVCs) in area-level cross-sectional analyses. The objectives of the study were to (1) Determine the effect on PMVC rates of newly implemented crossing guards in Toronto, Canada (2) Determine where collisions were located in relation to crossing guards throughout the city, and whether they occurred during school travel times.MethodsSchool crossing guards with 50 m buffers were mapped along with police-reported child PMVCs from 2000–2011. (1) A quasi-experimental study identified all age collision counts near newly implemented guards before and after implementation, modeled using repeated measures Poisson regression adjusted for season and built environment variables. (2) A retrospective cohort study of all child PMVCS throughout the city to determine the proportions of child PMVCs which occurred during school travel times and at guard locations.ResultsThere were 27,827 PMVCs, with 260 PMVCs at the locations of 58 newly implemented guards. Repeated measures adjusted Poisson regression found PMVCs rates remained unchanged at guard locations after implementation (IRR 1.02, 95 % CI 0.74, 1.39). There were 568 guards citywide with 1850 child PMVCs that occurred at guard locations. The majority of child PMVCs occurred outside school travel times (n = 1155, 62 %) and of those that occurred during school travel times, only 95 (13.7 %) were at a guard location.ConclusionsSchool crossing guards are a simple roadway modification to increase walking to school without apparent detrimental safety effects. Other more permanent interventions are necessary to address the frequency of child PMVCs occurring away from the location of crossing guards, and outside of school travel times.

Back-over Collisions in Child Pedestrians from the Canadian Hospitals Injury Reporting and Prevention Program

Objective: The objective of the current study was to describe the burden of back-over collisions within the context of other child pedestrian collisions as identified through a pediatric emergency room injury surveillance database. Methods: Injury data for child pedestrian motor vehicle collisions from 1994 to 2003 were obtained from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). Back-over collisions involving children under the age of 14 were identified and classified by written narratives. Characteristics of children involved in back-over collisions were described, and for those admitted to hospital, the nature of injury was compared with other types of child pedestrian collisions. Results: There were 4295 child pedestrian motor vehicle collisions reported to CHIRPP during the study time period. Of the 4295 children, 148 (3.4%) were injured in a back-over collision, with 49 (33.1%) of these collisions involving a vehicle backing out of a driveway. Children involved in back-over collisions were significantly younger than those in forward-moving/other collisions; however, almost 50 percent of back-over collisions involved children older than age 4. Children involved in back-over collisions on driveways were significantly younger than those involved in collisions occurring at other locations. Of those admitted to hospital, children in back-over collisions were more likely to sustain injuries to internal organs. Children in back-over collisions were less likely to sustain severe/mild head injuries and hip/leg fractures. Conclusions: Although back-over collisions represent a small proportion of pedestrian motor vehicle collisions, they tend to involve more severe injuries, as indicated by their admission to hospital. It was found that older children are also at risk of back-over collisions and back-over collisions occur in areas other than driveways. In order to lessen the burden of back-over collisions, interventions must address children of different ages and a variety of locations.

A geographic analysis of motor vehicle collisions with child pedestrians in Long Beach, California: comparing intersection and midblock incident locations

Objectives—The purpose of this study was to use geographic information system (GIS) software to locate areas of high risk for child pedestrian-motor vehicle collisions in the city of Long Beach...

Tricuspid regurgitation following central line insertion in a patient undergoing haemodialysis.

<h3>Background</h3> Road traffic injury is the leading cause of death for children in Canada. Lower speed roads are correlated with lower pedestrian injury severity. Pedestrians are 8 times more likely...