Child Pedestrians Research Articles

The Development of Child Pedestrian Training in the United Kingdom 2002–2011: A National Survey of Local Authorities

Approximately two thirds of the children killed or seriously injured on Great Britain's roads are child pedestrians. Recognizing this issue, the Department for Transport introduced and evaluated a pilot child pedestrian training scheme, Kerbcraft, from 2002 to 2007. Kerbcraft aimed to teach roadside pedestrian skills to children between age 5 and 7 and was successfully trialled across 75 local authorities in England and Scotland. The UK government has since recommended Kerbcraft as the best practice example for roadside child pedestrian training. This article revisits a sample of local authorities that participated in the pilot and presents the findings from a new survey: identifying the status of child pedestrian training and assessing how the delivery, evaluation, and learning mechanisms have changed since the pilot. The results suggest that following on from the Kerbcraft scheme, the majority of local authorities continue to provide pedestrian training but in an adapted form—often delivering less training than that suggested by the Kerbcraft model. The implications are discussed.

Spatial Analysis of Child Pedestrian and Bicycle Crashes

Pedestrian and bicycle safety for school-aged children is a particular concern as traffic crashes continue to be a leading cause of death for children 5 to 14 years old. For this concern to be addressed, Safe Routes to School (SRTS) programs have been implemented in communities across the country, with one of the primary objectives being to provide safe and convenient routes for children to walk or bike to school. Unfortunately, SRTS programs allocate limited funding for such projects. Consequently, it is imperative that programs are implemented at locations where they are likely to have the greatest impact. The primary focus of this study was to develop a safety Performance function (SPF) for use in prioritizing candidate schools for SRTS programs. Traffic crashes over a 5-year analysis period were examined and linked to data that included the school enrollment, the socioeconomic and demographic data for each school district, and the functional class of the roadway on which each school was located. Schools on local roads were found to experience more crashes than those located on other, higher-class road facilities. Crashes also varied with average family size, number of parents per household, population density, and median family income. Crashes were less frequent in school districts that exhibited greater ethnic diversity. The SPF developed as a part of this research can be used for prioritization of candidate schools as well as to assess the efficacy of SRTS programs on a longitudinal basis and thus provide a valuable tool for school administrators and others involved in child pedestrian and bicycle safety.

Gender differences in road traffic injury rate using time travelled as a measure of exposure

There is no consensus on whether the risk of road traffic injury is higher among men or among women. Comparison between studies is difficult mainly due to the different exposure measures used to estimate the risk. The measures of exposure to the risk of road traffic injury should be people's mobility measures, but frequently authors use other measures such population or vehicles mobility. We compare road traffic injury risk in men and women, by age, mode of transport and severity, using the time people spend travelling as the exposure measure, in Catalonia for the period 2004–2008. This is a cross-sectional study including all residents aged over 3 years. The road traffic injury rate was calculated using the number of people injured, from the Register of Accidents and Victims of the National Traffic Authority as numerator, and the person-hours travelled, from the 2006 Daily Mobility Survey carried out by the Catalan regional government, as denominator. Sex and age specific rates by mode of transport and severity were calculated, and Poisson regression models were fitted. Among child pedestrians and young drivers, males present higher risk of slight and severe injury, and in the oldest groups women present higher risk. The death rate is always higher in men. There exists interaction between sex and age in road traffic injury risk. Therefore, injury risk is higher among men in some age groups, and among women in other groups, but these age groups vary depending on mode of transport and severity.

Severity of child pedestrian injuries due to bonnet‐type‐vehicle collision

The aim of this study was to clarify the pattern of child pedestrian injury, injury severity, and its relation to collision velocity in bonnet-type-vehicle collision. In-depth data were retrospectively collected from the Institute for Traffic Accident Research and Data Analysis on pedestrians younger than 13 years old with any bodily injuries from collisions with bonnet-type vehicles between 1993 and 2004. Forty-seven patients from 43 collisions with a mean age of 6.9 ± 2.5 years were included in the study. Injury severity was not significantly different between patients who were hit by the front of the vehicle and those who were hit by the side of the vehicle. In front collisions, impact with the vehicle was associated with significantly higher Abbreviated Injury Scale (AIS) scores than those for impact with the road, especially for the lower extremities (mean: 1.2 vs 0.2, P < 0.001). Injury severity of the lower extremities and collision velocity were examined. The estimated collision velocity of the vehicle was not significantly different between patients with lower extremity AIS scores of 0 or 1 and those of 2 or 3. Some pediatric pedestrians suffer from collisions with bonnet-type vehicles without lower extremity fractures owing to the characteristics of child pedestrians. Providing injury prevention programs for children in communities and schools, developing active safety devices in the vehicle, and modifying the vehicle body to a pediatric pedestrian-friendly structure may increase pedestrian protection.

Towards understanding child-pedestrians’ hazard perception abilities in a mixed reality dynamic environment

Child-pedestrians, especially those in the age range of 5–9-years, are amongst the most vulnerable road users. These youngsters are highly represented in fatal and severe injury road crashes, despite relatively low levels of exposure to traffic. The present research investigated child and adult pedestrians’ perception of hazards utilizing a crossing decision task. Twenty-one adults (20–27years-old) and twenty-five young-children (eight 7–9-year-olds, five 9–10-year-olds and twelve 10–13-year-olds) were requested to observe traffic-scene scenarios presented in a mixed reality dynamic environment simulating a typical Israeli city from a pedestrian’s perspective, and to press a response button whenever they assumed it was safe to cross. Results have shown that as pedestrians’ age and experience-level increased their attentiveness towards potential hazards increases and their ability to anticipate upcoming events while engaging in a road-crossing task was enhanced. Furthermore, both the 9–10-year-olds and the 10–13-year-olds presented a less decisive performance compared to both the experienced-adult pedestrians and the 7–9-year-olds. Understanding child-pedestrians’ shortcomings in evaluating traffic situations may contribute to the effort of producing intervention techniques which may increase their attentiveness towards potential hazards and pave the way for reducing their over-involvement in road crashes. Implications for training novice road users will be discussed.

Analysis of child–vehicle collision injuries by vehicle type

PurposeThis study aimed to determine the severity of injuries to each body region of child pedestrians struck by different types of vehicles. MethodsWe collected in-depth data from the Institute for Traffic Accident Research and Data Analysis on pedestrians younger than 13 years with any bodily injuries from collisions with vehicles between 1993 and 2004. ResultsSixty-eight patients with a mean age of 6.9 ± 2.4 years were included in the study. In collisions, vehicles caused higher Abbreviated Injury Scale (AIS) scores than those from impact with the road. Injury Severity Score and AIS values were higher with one-box or sports utility vehicles compared with those in sedan vehicles, but the differences were not statistically significant. The mean AIS score of head injuries was significantly higher with one-box or sports utility vehicles than that with sedans (1.6 ± 2.1 vs 0.5 ± 1.1, P < .05). The mean AIS score of the lower extremities was significantly higher with sedans than that with one-box or sports utility vehicles (1.2 ± 1.0 vs 0.5 ± 0.9, P < .05). ConclusionsThe type and severity of injuries in child–car collisions vary by type of vehicle and pedestrian kinematics.

A sustainable city environment through child safety and mobility—A challenge based on ITS?

Our cities should be designed to accommodate everybody, including children. We will not move toward a more sustainable society unless we accept that children are people with transportation needs, and ‘bussing’ them around, or providing parental limousine services at all times, will not lead to sustainability. Rather, we will need to make our cities walkable for children, at least those above a certain age. Safety has two main aspects, traffic safety and personal safety (risk of assault). Besides being safe, children will also need an urban environment with reasonable mobility, where they themselves can reach destinations with reasonable effort; else they will still need to be driven. This paper presents the results of two expert questionnaires focusing on the potential safety and mobility benefits to child pedestrians of targeted types of intelligent transportation systems (ITS). Five different types of functional requests for children were identified based on previous work. The first expert questionnaire was structured to collect expert opinions on which ITS solutions or devices would be, and why, the most relevant ones to satisfy the five different functional requests of child pedestrians. Based on the first questionnaire, fifteen problem areas were defined. In the second questionnaire, the experts ranked the fifteen areas, and prioritized related ITS services, according to their potential for developing ITS services beneficial to children. Several ITS systems for improving pedestrian quality are discussed. ITS services can be used when a pedestrian route takes them to a dangerous street, dangerous crossing point or through a dangerous neighborhood. An improvement of safety and other qualities would lead to increased mobility and a more sustainable way of living. Children would learn how to live to support their own health and a sustainable city environment. But it will be up to national, regional and local governments, through their ministries and agencies and public works departments, to promote, fund, and possibly mandate such systems. It is clear that we need to offer an acceptable level of convenience, efficiency, comfort, safety and security to pedestrians but it is less clear if society will prioritize resources toward this.

Trends in head injuries associated with mandatory bicycle helmet legislation targeting children and adolescents

BackgroundBicycling related head injuries (HIs) can be severe. Helmet use reduces head injury risk; however, there are few controlled studies of the effect of helmet legislation. We conducted this study to investigate changes in HIs after bicycle helmet legislation targeting those <18 in Alberta, Canada in 2002. MethodsBicyclist and pedestrian (control) HI rates and HIs as a proportion of all injuries were compared for the three years (1999–2001) before and four years (2003–2006) after bicycle helmet legislation in three age groups (children: <13, adolescents: 13–17, and adults: 18+). ResultsThere were 41,270 ED visits and 2782 hospitalizations for bicyclists and 9836 ED visits and 2029 hospitalizations for pedestrians (excluding the legislation year 2002). The rate of ED HIs declined for child bicyclists and child pedestrians, while the rate of non-HIs declined in adult bicyclists and child pedestrians. The rate of hospitalized HIs declined in child bicyclists and all ages of pedestrians while non-HI rates declined for child and adult pedestrians. Non-HI rates for adolescent and adult bicyclists increased. After adjusting for sex and location, the proportion of ED bicycle HIs declined by 9% (APR=0.91; 95% CI: 0.86, 0.95) in children, was unchanged among adolescents and increased in adults (APR=1.08; 95% CI: 1.01, 1.15). The proportion of bicycle HI related hospitalizations decreased by 30% (APR=0.70; 95% CI: 0.55, 0.90) in children, 36% (APR=0.64; 95% CI: 0.49, 0.84) in adolescents and 24% (APR=0.76; 95% CI: 0.63, 0.91) in adults. There were no observed changes in the proportion of pedestrian HIs resulting in ED visits or hospitalizations. InterpretationOur data indicate significant declines in the proportion of child bicyclist ED HIs and child, adolescent and adult bicyclist HI hospitalizations. This is in contrast to no significant trends in the proportion of ED or hospitalized HIs among pedestrians and the unexpected increases in the proportion of ED HIs for adult bicyclists. Comparing bicyclist and pedestrian trends in the proportion of child and adolescent HIs suggests a bicycle helmet legislation effect.

Altering School Attendance Times to Prevent Child Pedestrian Injuries

Objectives: The purpose of this research was to determine whether modifying school start time schedules can be used to reduce children's exposure to traffic on their morning walks to school. Methods: We use models of pedestrian and motor vehicle commuting to estimate the frequency of encounters between child pedestrians and motor vehicles at intersections throughout the City of Hamilton, Ontario, Canada. We use a simple heuristic to identify the school-specific start times that would most reduce the local frequency of encounters between motor vehicles and pedestrians. Results: Our analysis suggests that it may be possible to achieve an almost 15 percent reduction in the total number of encounters between child pedestrians and motor vehicles during the morning commute by staggering school start times such that the periods of high pedestrian activity are temporally staggered from periods of high motor vehicle activity. Our analysis suggests that small changes in school start times could be sufficient to see noteworthy reductions in pedestrian exposure to traffic. Conclusions: Changing school times may be an effective, inexpensive, and practical tool for reducing child pedestrian injuries in urban environments. Enhanced transportation models and community-based interventions are natural next steps for exploring the use of school-specific scheduling to reduce the risk of child pedestrian injury. Further research is required to validate our models before this analysis should be used by policy makers.

BIOMECHANICAL ANALYSIS OF THE DUMMY RESPONSES IN CASE OF CHILD PEDESTRIAN/CYCLIST COLLISION WITH PASSENGER CAR

The safety of pedestrians and cyclists in traffic is justified especially in terms of prevention. This paper deals with the biomechanical analysis of load exerted on the child pedestrian and cyclist. In the case of cyclists, the impact configurations were chosen with respect to the statistical outputs (sudden enter the road or the case of non-giving way; the car front vs. the left side of the cyclists). Two tests were performed in the same configuration and nominal collision speed, the first one with a bicycle helmet and the second one without the helmet. The initial position of pedestrian was chosen with respect to the dummy degrees of freedom. Using the accelerometers in the head, chest, pelvis and knee of the dummy acceleration fields were detected, which are the child pedestrian and cyclist exposed during the primary and secondary collision. In addition, prediction diagnostics method implementation was discussed such as one possible solution of vulnerable road users harm reduction. In conclusion, the results are interpreted by values of biomechanical load and severity of potential injuries including kinematic and dynamic comparison.

The Usability and Effectiveness of Interactive Video as a Complementary Child Pedestrian Training Activity

Practical on-street pedestrian training is one form of education designed to promote safe roadside behavior amongst young road users with the intention of reducing their potential of involvement in road traffic collisions. While many local authorities in the United Kingdom operate pedestrian training, a number are reducing the amount of on-street training on offer as a result of financial and time constraints. This reduction in practical training puts more emphasis on paper-based classroom activities which increase knowledge acquisition but are generally not as effective in improving practical skills. Interactive videos may prove to be an effective complementary activity alongside pedestrian training as it is suggested that they can more effectively target hard skills compared to paper-based activities. This paper evaluates the effectiveness of an interactive road safety video designed to improve children’s crossing skills between parked cars when no other alternative safer route is available. The paper finds that interactive video shows the potential to improve the crossing behavior of children and that it therefore may make a useful additional educational activity alongside pedestrian training.

The road most travelled: the geographic distribution of road traffic injuries in England.

BackgroundBoth road safety campaigns and epidemiological research into social differences in road traffic injury risk often assume that road traffic injuries occur close to home. While previous work has examined distance from home to site of collision for child pedestrians in local areas, less is known about the geographic distribution of road traffic injuries from other modes. This study explores the distribution of the distance between home residence and collision site (crash distance) by mode of transport, geographic area, and social characteristics in England.MethodsUsing 10 years of road casualty data collected by the police, we examined the distribution of crash distance by age, sex, injury severity, area deprivation, urban/rural status, year, day of week, and, in London only, ethnic group.Results54% of pedestrians, 39% of cyclists, 17% of powered two-wheeler riders and 16% of car occupants were injured within 1 km of home. 82% of pedestrians, 83% of cyclists, 54% of powered two-wheeler and 53% of car occupants were injured within 5 km of home. We found some social and geographic differences in crash distance: for all transport modes injuries tended to occur closer to home in more deprived or urban areas; younger and older pedestrians and cyclists were also injured closer to home. Crash distance appears to have increased over time for pedestrian, cyclist and car occupant injuries, but has decreased over time for powered two-wheeler injuries.ConclusionsInjuries from all travel modes tend to occur quite close to home, supporting assumptions made in epidemiological and road safety education literature. However, the trend for increasing crash distance and the social differences identified may have methodological implications for future epidemiological studies on social differences in injury risk.

Risk Factors Associated with Injury and Mortality from Paediatric Low Speed Vehicle Incidents: A Systematic Review

Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover (LSVRO) incidents involving children aged 0–15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries from the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study inclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk factors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5 years, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies identified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with LSVRO injury. Vehicles were most commonly driven by a family member, predominantly a parent. Conclusion. There are a number of modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been identified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance systems), housing design (physical separation of driveway and play areas), and behaviour (driver behaviour, supervision of young children) are discussed.

The effects of local and non-local traffic on child pedestrian safety: A spatial displacement of risk

In most places, motor-vehicle traffic volume is associated with increased risk of child pedestrian injury; however, the burden of risk is geographically complex. In some neighbourhoods, proportionally fewer drivers may be local, meaning that the moral and practical responsibility of risk to children is displaced from one place (e.g., the suburbs) to another (e.g., downtown). Using the City of Toronto, Canada, as a case study, this research asks two related questions: 1) what is the variation in traffic volume by neighbourhood of origin and socioeconomic status and 2) what is the relationship between the geographical origin of traffic and the risk of collisions involving child pedestrians and motor-vehicles? We find that low-income downtown neighbourhoods have the highest proportion of non-local traffic. We also find that while higher local traffic activity is associated with lower risk of collision, higher flow-through traffic activity (excluding traffic from major thoroughfares) is associated with higher risk of collision. We interpret the former as very likely a proxy of parents' frequency of chauffeuring children to school, and the latter an illustration of the spatial displacement of risk between Toronto neighbourhoods. Our results suggest that more attention needs to be paid to account for the externalization of harm experienced by children, particularly in low-income downtown neighbourhoods.

Quantifying the Effect of Area Deprivation on Child Pedestrian Casualties by Using Longitudinal Mixed Models to Adjust for Confounding, Interference and Spatial Dependence

SummaryThe paper investigates the link between area-based socio-economic deprivation and the incidence of child pedestrian casualties. The analysis is conducted by using data for small spatial zones within major British cities over the period 2001–2007. Spatial longitudinal generalized linear mixed models, estimated by using frequentist and Bayesian approaches, are used to address issues of confounding, spatial dependence and transmission of deprivation effects across zones (i.e. interference). The results show a consistent strong deprivation effect across model specifications. The incidence of child pedestrian casualties in the most deprived zones is typically greater than 10 times that in the least deprived zones. Modelling interference through a spatially auto-regressive covariate uncovers a substantially larger effect.

Injury patterns and safety behaviour of child pedestrians in the ultra Orthodox Jewish Community

BackgroundRoad crashes are a primary cause of injury among children in Israel. The Ultra-Orthodox Jewish (UOJ) population in Israel is characterised by low socioeconomic status, large families, low employment, and...

Do child pedestrians deliberately take risks when they are in a hurry? An experimental study on a simulator

In order to ascertain whether or not child pedestrians voluntarily take risks, a street-crossing task in an urban environment with vehicle traffic was administered individually to 80 children aged 10 years using a pedestrian simulator. The task, which was presented as a contest, consisted of attaining two objectives in a limited time. The subjects were divided into three conditions that differed only in the number of constraints that had to be taken into account in order to win the contest. The data show that the degree of urgency felt, measured by the amount of time taken, increased as the number of constraints increased. At the same time, the frequency of two of the risky behaviors (not using the pedestrian crossing, running across the road) increased, whereas the frequency of observation failures was independent of the condition. Not using the pedestrian crossing and running across the road were therefore deliberately taken risks, whereas observation failures can be attributed to a control deficit. The discussion includes suggestions for training.

Vulnerable Child Pedestrians in Rapidly Motorizing Developing Countries

The global economic burden of motor vehicle crashes and pedestrian injuries is approximately $500 billion. Children are most vulnerable to being struck by a motor vehicle because they are often impulsive and lack the integrated sensory and cognitive skills required to judge the risks of oncoming traffic.1 It is predicted that pedestrian road deaths will increase by 65% in the next 10 years.2

Promoting Child Pedestrian Injury Research.

Promoting Child Pedestrian Injury Research.

Risk Factors for Child and Adolescent Occupants, Bicyclists, and Pedestrians in Motorized Vehicle Collisions

Objective: The aim was to use similar population data to examine the relative risk of collision injury among children of different ages and adolescents involved in various collision types and to elucidate the possible risk factors related to road collisions involving children and adolescents in a large, 2-wheeled vehicle environment. Methods: We used data from a society with a large population of motorcyclists to examine the relative risk of injury among children and adolescents aged 0 to 6, 7 to 9, 10 to 12, 13 to 15, and 16 to 17 years old who were involved in single motorized vehicle, multiple motorized vehicle, bicycle-to-vehicle, and pedestrian-to-vehicle collisions. Police reports for 73,232 collision injuries between the years 2003 and 2009 were analyzed using multicategory logit models of the 4 collision types. Results: Young (particularly 0- to 6-year-old) child bicyclists and pedestrians were the most sensitive to several factors. In collisions, young child bicyclists making U-turns or being struck by forward-moving or right-turning motorized vehicles, on local roads, during the daytime, or at locations without traffic signals had the greatest risk of injury. Similarly, young child pedestrians running, during the daytime, or at locations without traffic signals had a significant risk of injury. After controlling for other factors, we found that 4-wheeled motorized vehicles, not motorcycles, presented a higher risk for injury to child passengers, bicyclists, and pedestrians. Conclusions: The risk of collision injury varied for the different groups of children in the 4 collision types. To reduce the risk of injury for young children, we recommend the development of road-crossing training tools for parents. In addition, the behaviors of children should be taken into consideration when developing in-vehicle assistance systems.