Child Pedestrians Research Articles

Understanding the Factors Affecting Traffic Danger for Children: Insights From Focus Group Discussions

Children’s safety on urban roads is a critical concern with young pedestrians and cyclists being among the most vulnerable groups to traffic-related dangers. The prioritization of motor vehicle traffic in road infrastructure poses significant risks to child pedestrians and cyclists navigating city streets. Furthermore, children’s independent mobility has been restricted due to traffic danger and their parents’ concerns about it. Given the important implications of this issue, a serious gap was identified in that no measure of traffic danger exists, with outcomes (e.g., collisions) being used as a proxy. Identifying factors contributing to traffic danger, how they interact, and how they impact traffic are imperative to identify where mitigation is needed to address these problems. This article delves into the complexities of traffic risks for children, focusing on intersections and streets. Six focus groups, including experts (<em>n</em> = 3), parents (<em>n</em> = 2), and children aged 8 to 12 (<em>n</em> = 1), were conducted to gather insights on factors impacting traffic danger. Thematic analysis revealed eight key themes, highlighting the importance of addressing traffic volume, speed, vehicle size, road design, driver behavior, visibility, and land use. These findings contribute to a comprehensive framework for understanding traffic danger for children. Additionally, the article examines how stakeholders’ perspectives align with standard measures of traffic danger in the literature.

Safe curb parking distance near school-gate ensuring child pedestrians' safety

Safe curb parking distance near school-gate ensuring child pedestrians' safety

Road Fatalities in Children Aged 0-17: Epidemiological Data and Forensic Aspects on a Series of Cases in a Single-Centre in Romania.

Road Traffic Accidents (RTAs) are the leading cause of premature death in young people aged 5-29. Globally, 186,300 children aged 9 years and under die from RTAs each year. Romania had the highest mortality rate in children aged 0 to 14 for 2018-2020. This study aimed to assess the involvement of children aged 0-17 years in fatal RTAs by analyzing medico-legal autopsy records in a 5-year period at Timisoara Institute of Legal Medicine (TILM), Romania. A retrospective analysis of medico-legal autopsy records of road fatalities in children aged 0-17 years, from TILM in a 5-year period (2017-2021), was conducted. Of all medico-legal autopsies in the 5-year period, 23 cases (5.8%) involved road fatalities in children aged 17 and under. Preschoolers accounted for 10 cases, followed by the age group 15-17 years (n = 9). Most children sustained fatal injuries as passengers (n = 13), followed by child pedestrians (n = 7). This research follows four representative cases, each being a different type of child road fatality regarding the type of road user, the age of the victim, and the involvement of other risk factors. Our findings emphasize the tragedy of road fatalities in children and the need to determine risk factors and prevention strategies to reduce the enormous global crisis involving these vulnerable victims.

Injury and fatality risks for child pedestrians and cyclists on public roads

BackgroundPedestrians and cyclists are often referred to as “vulnerable road users,” yet most research is focused on fatal crashes. We used fatal and nonfatal crash data to examine risk factors (i.e., relationship to an intersection, urbanicity, crash circumstances, and vehicle type) for police-reported pedestrian and cyclist injuries on public roads among children aged 0–9 and aged 10–19. We also compared risk factors among these two age groups with adults aged 20–29 and aged 30–39.MethodsCrash data were obtained for 2016–2020 from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System for fatal crash injuries and Crash Report Sampling System for nonfatal crash injuries. We collected data on victim demographics, roadway, and vehicle- and driver-related factors. Descriptive analyses were conducted between and within pedestrian and cyclist victims.ResultsWe analyzed 206,429 pedestrian injuries (36% in children aged 0–19) and 148,828 cyclist injuries (41% in children aged 0–19) from 2016 to 2020. Overall, child pedestrians had lower injury rates than adults, but children aged 10–19 had greater cycling crash rates than adults. Almost half of the pedestrian injuries in children aged 0–9 were “dart-out” injuries (43%). In the majority of the cyclist injuries, children in both age groups failed to yield to vehicles (aged 0–9 = 40% and aged 10–19 = 24%). For children and all ages included in the study, the fatality risk ratio was highest when pedestrians and cyclists were struck by larger vehicles, such as trucks and buses. Further exploration of roadway factors is presented across ages and transportation mode.ConclusionOur findings on child, driver, vehicle, and roadway factors related to fatal and nonfatal pedestrian and cyclist injuries may help to tailor prevention efforts for younger and older children.

Child Pedestrians’ Perception of External Car Display: Effects of Communication Style and Visualization Type on Trust and Perceived Safety

Child Pedestrians’ Perception of External Car Display: Effects of Communication Style and Visualization Type on Trust and Perceived Safety

Driver yield and safe child pedestrian crossing behavior promotion by a school traffic warden program at primary school crossings: A cluster-randomized trial

Objective To determine the effect of a school traffic warden program on increasing driver yield and safe child pedestrian crossing behavior in Kampala, Uganda. Methods We designed and implemented a school traffic warden program in specific school zones in Kampala, Uganda. We randomly assigned 34 primary schools in Kampala, in a 1:1 ratio, using a computer-generated randomization sequence, to control or intervention arms in a cluster randomized trial. Each school in the intervention group received one trained adult traffic warden stationed at roads adjacent to schools to help young children safely cross. The control schools continued with the standard of care. We extracted and coded outcome data from video recordings on driver yield and child crossing behavior (defined as waiting at the curb, looking both ways for oncoming vehicles, not running while crossing, and avoiding illegal crossing between vehicles) at baseline and after 6 months. Using a mixed effect modified Poisson regression model, we estimated the prevalence ratio to assess whether being in a school traffic warden program was associated with increased driver yield and safe crossing behavior. Results A higher proportion of drivers yielded to child pedestrians at crossings with a school traffic warden (aPR 7.2; 95% CI 4.42–11.82). Children were 70% more likely to demonstrate safe crossing behavior in the intervention clusters than in control clusters (aPR 1.7; 95% CI 1.04–2.85). A higher prevalence was recorded for walking while crossing (aPR 1.2; 95% CI 1.08–1.25) in the intervention clusters. Conclusion The school traffic warden program is associated with increased driver yield and safe child pedestrian crossing behavior, i.e., stopping at the curb, walking while crossing, and not crossing between vehicles. Therefore, the school traffic warden program could be promoted to supplement other road safety measures, such as pedestrian safety road infrastructure, legislation, and enforcement that specifically protects children in school zones.

Estimating disease burden of rotavirus in floodwater through traffic in the urban areas: A case study of Can Tho city, Vietnam

AbstractMicrobial pathogens in urban floodwaters pose risks to human health, potentially causing diseases such as diarrhea. However, the disease burden related to urban traffic exposure from citizens passing through floodwaters is not easily quantified and therefore not included in many studies. Notably, this problem has received little attention in low‐to‐middle‐income countries, with frequent flood events and the heavy diarrheal disease burden. This article calculates the infection risks and disease burden, considering traffic associated with exposure to floodwater contaminated with rotavirus for the first time in Ninh Kieu District, Can Tho city. Can Tho city in the Vietnamese Mekong Delta is well known to have many flood events every year, with many diarrheal cases during the flood season. The methodology comprises two steps. First, we applied quantitative microbial risk assessment that proposes the inclusion of exposure to traffic due to rotavirus in floodwater. Second, the disease burden was expressed in disability‐adjusted life years (DALYs). The exposed groups are child pedestrians, adult pedestrians, motorcyclists, and cyclists. We used video footage to monitor the traffic. The results show that total DALYs per flood event were 1.35 × 104 for 63,390 exposed people (i.e., 2129 DALYs per 10,000 cases). Motorcyclists are the strongest contributors to the DALYs (95%), followed by cyclists (2.8%), adult pedestrians (2%), and child pedestrians (0.2%). The population in Ninh Kieu District may suffer from waterborne diseases through traffic activities during flooding times. Our approach can be applied in other areas worldwide and helps identify main risk groups and focus areas for interventions.

Child pedestrian crossing behaviour and associated risk factors in school zones: a video-based observational study in Kampala, Uganda

BackgroundPedestrian crashes, often occurring while road crossing and associated with crossing behaviour, make up 34.8% of road casualties in Uganda. This study determined crossing behaviour and associated factors among child...

A ward level analysis of child pedestrian casualty frequencies in Greater London

Introduction: Child pedestrian safety remains a challenge despite the remarkable progress that has been attained in recent years, particularly, in high income jurisdictions such as London. This study sought to identify and quantify the magnitude of the effects of various explanatory variables, from the domains of transport, built and natural environment, socio-demographic and economic factors, on ward level child pedestrian injury frequencies in Greater London. Method: We adopted a multilevel random parameters model to investigate the factors associated with child pedestrian injuries given the hierarchical nature of the data comprising of wards nested within boroughs. Results: We found that crime, the Black, Asian, and Minority Ethnic (BAME) population, school enrollment, and the proportion of the population who walk five times a week had an increasing effect on the number of child pedestrian casualties. Conversely, the proportion of the population with a level 4 qualification and the number of cars per household had a decreasing effect. Conclusions: Our study identified high child pedestrian injury frequency wards and boroughs: Stratford and New Town had the highest expected child pedestrian injury frequencies followed by Selhurst, Westend, and Greenford Broadway. Some inner London boroughs are among the highest injury frequency areas; however, a higher number of high child pedestrian injury boroughs are in outer London. Practical Applications: The paper provides recommendations for policy makers for targeted child pedestrian safety improvement interventions and prioritization to optimize the utilization of often constrained resources. The study also highlights the importance of considering social inequities in policies that aim at improving child traffic safety.

Development and validation of a video-based assessment tool for children's street-crossing safety

BackgroundThe alarming rate of child pedestrian fatalities highlights an urgent imperative for comprehensive test on children's street-crossing safety. Various methods in children's street-crossing studies were reviewed, and the advantages of the video-based experimental real-walk methods were introduced. AimThe present study aimed to develop a reliable assessment tool to evaluate children's crossing safety, assess its validity, and identify developmental characteristics of children's crossing abilities. MethodsWe recorded scenarios of vehicle-pedestrian interactions with varying distances and speeds at multiple suburban zebra crossings without traffic lights, and projected the videos to guide participants through a realistic crossing experience indoors. Sixty children, with 20 in each age group of 6, 8, and 11 years old (with equal numbers of boys and girls), were recruited. The children's crossing safety was measured using the dangerous crossing (DC), safe crossing rate (SCR) and time to contact (TTC), and they were also asked to complete the Chinese version of the Pedestrian Behavior Scale (CPBS). Their eye movements were also recorded with a portable eye tracker. ResultsThe correlation analysis of the simulated street-crossing video test revealed significant associations between behavioral indicators (DC, TTC), CPBS, and eye movement indicators, indicating strong empirical validity. Difficulty analysis confirmed the relatively high SCR among child pedestrians across all three age groups. Discriminant validity analysis demonstrated that age significantly predicted children's crossing safety, with 6-year-olds exhibiting lower safety in both behavioral and attentional dimensions compared to 8-year-olds and 11-year-olds. Finally, predictive validity results indicated varying effects of TTC on CPBS scores across different age groups, with a more significant predictive effect for younger children possessing lower street-crossing abilities. ConclusionThe video test effectively verified the critical period and developmental trend of children's crossing ability and demonstrated high validity. Overall, the developed video test is an effective tool for assessing school-aged children's crossing safety.

Child Pedestrian Safety.

The field of pedestrian safety has advanced with new evidence related to pediatric pedestrian education, the risks of distracted walking, the benefits of design and programming in safe routes to school, and the emergence of the "Vision Zero" strategy to eliminate all traffic fatalities and severe injuries while increasing safe, healthy, equitable mobility for all. This statement is a revision of the 2009 American Academy of Pediatrics policy statement "Pedestrian Safety" and is accompanied by a technical report (www.pediatrics.org/cgi/doi/10.1542/peds.2023-062508) providing additional detail to support recommendations. This statement is intended to assist practicing pediatricians to offer evidence-based advice to families about the benefits of active transportation and the specific risks and safety precautions to consider for child pedestrians at different ages. For community pediatricians and the American Academy of Pediatrics, the statement provides an overview of specific programs and policies that, if implemented, could foster independent mobility for children while increasing pediatric pedestrian safety. This statement identifies trends in public health and urban design relevant to pedestrian safety.

Epidemiology and Prevention of Child Pedestrian Injury.

This report supports policy recommendations in the accompanying policy statement "Child Pedestrian Safety" (www.pediatrics.org/cgi/doi/10.1542/peds.2023-62506). It reviews trends in public health and urban design relevant to pedestrian safety and provides information to assist practicing pediatricians discussing the benefits of active transportation and the specific risks and safety precautions to consider for child pedestrians at different ages. The report offers the evidence base for which programs and policies that, if implemented, could foster independent mobility for children while increasing pediatric pedestrian safety. Since the previous policy statement was published in 2009, the field of pedestrian safety has advanced with new evidence related to pediatric pedestrian education, the risks of distracted walking, the benefits of design and programming in safe routes to school, and the emergence of the "Vision Zero" public health and safety initiatives to prevent all serious and fatal transportation injuries.

A comprehensive study of child pedestrian crash outcomes in Ghana

Pedestrians are considered as one of the vulnerable road user groups. Among pedestrians of all ages, children are the most at risk. Previous studies have shown that children have inadequate knowledge of road safety and are unable to identify risks on road. Despite these limitations associated with children, society places the burden on them to protect themselves. However, to be able to adequately address child pedestrian safety issues there is the need to understand the factors that influence their crash involvement and severity of injury they sustain. To address this gap, this study performed a comprehensive analysis of historical crash data in Ghana to find holistic countermeasures for these crashes. The study used five years of child pedestrian (below 10 years) crash records obtained from the Building and Road Research Institute (BRRI) in Ghana. A temporal analysis of the data revealed that the highest number of the crashes coincide with when school-going children go to and close from school. A random parameter multinomial logit model was developed to identify crash variables that are significantly associated with child pedestrian crash outcomes. The estimation results revealed that children are likely to be killed in crashes when the driver is speeding and inattentive. Also, it was found that children walking along the road, crossing the road, and those in urban areas are more susceptible to incapacitating injury crashes. Male drivers accounted for 95.8% of child pedestrian crashes, and crashes involving male drivers are 7.8% more likely to be fatal.The findings from this study provide a deeper, data-driven understanding of child pedestrian crashes and how temporal characteristics, vehicle type, location of pedestrian, traffic operation, and environmental and human factors affect crash outcomes. These findings will help in developing countermeasures like providing conspicuous pedestrian crossings, footbridges on multi-lane high-speed roadways, and the use of school buses to convey students to help mitigate the number and severity of child pedestrian crashes in Ghana, and by extension other countries in the sub-region.

The Application of Theory of Planned Behaviour in Pedestrian Safety: A Literature Approach

Road accidents among pedestrian become an important issue that needs to be mitigated due to high injuries and fatalities cases. Pedestrian is a weakest group of people compared to the drivers because they are not fully protected. The accidents involving pedestrian may occur due to their own negative crossing behaviour. This study is purposely to identify the effectiveness of theory of planned behaviour (TPB) in predicting pedestrian behaviour. TPB has three main constructs which are attitudes, subjective norms and perceived behavioural control that significant to behavioural intention. Some studies used extended TPB by adding other constructs such as moral norms, perceived risk, conformity tendency, perceived severity, and past behaviour to predict pedestrian behaviour more accurately. This study used a literature approach where some of the previous studies are examined and the results of the studies are being analysed using descriptive analysis. The results show that TPB is suitable to predict pedestrian behaviour because the constructs are significant and comply with its fit. This study also shows that pedestrian behaviours are differ according to their age and gender. Most of previous studied states that young people tends to perform risky behaviours compared to old people. Children pedestrian are more vulnerable and have a high tendency to involve in road accidents and have a high fatality risk. Men are more risk-taking compared to women and men have high tendency to violate road regulations and exposed to injuries and fatality while women have more positive crossing behaviour.

Walkability for children in Bologna: Beyond the 15-minute city framework

The current research work is based on an extended spatial analysis executed through the application of GIS, aiming at assessing the level of walkability in the city of Bologna (Italy). In particular, the research focused on walkability for children (aged between 5 to 13 years old), as they experience the city differently than adult pedestrians, since they are more vulnerable to road accidents and they need proper infrastructures to freely play outdoors and walk independently. The GIS analysis was based on a series of location-based data retrieved from different open source repositories and focused on the level of usefulness, comfort, safety, and attractiveness of Bologna for child pedestrians. The proposed Walkability for Children Index was aimed at identifying the neighborhoods characterized by the lowest level of pedestrian friendliness in relation to the childrens needs while walking. Results helped to identify and characterize a short list of suitable areas where to prioritize interventions focusing, for example, on guaranteeing the presence of relevant public services within a walkable distance of 15 minutes from place of residence and on the implementation of urban regeneration projects through the tactical urbanism approach.

A decade of child pedestrian safety in England: a Bayesian spatio-temporal analysis

BackgroundChild pedestrian injury is a public health and health equality challenge worldwide, including in high-income countries. However, child pedestrian safety is less-understood, especially over long time spans. The intent of this study is to understand factors affecting child pedestrian safety in England over the period 2011–2020.MethodsWe conducted an area-level study using a Bayesian space-time interaction model to understand the association between the number of road crashes involving child pedestrians in English Local Authorities and a host of socio-economic, transport-related and built-environment variables. We investigated spatio-temporal trends in child pedestrian safety in England over the study period and identified high-crash local authorities.ResultsWe found that child pedestrian crash frequencies increase as child population, unemployment-related claimants, road density, and the number of schools increase. Nevertheless, as the number of licensed vehicles per capita and zonal-level walking/cycling increase, child pedestrian safety increases. Generally, child pedestrian safety has improved in England since 2011. However, the socio-economic inequality gap in child pedestrian safety has not narrowed down. In addition, we found that after adjusting for the effect of covariates, the rate of decline in crashes varies between local authorities. The presence of localised risk factors/mitigation measures contributes to variation in the spatio-temporal patterns of child pedestrian safety.ConclusionsOverall, southern England has experienced more improvement in child pedestrian safety over the last decade than the northern regions. Our study revealed socio-economic inequality in child pedestrian safety in England. To better inform safety and public health policy, our findings support the importance of a targeted system approach, considering the identification of high-crash areas while keeping track of how child pedestrian safety evolves over time.

Simplified model of children-pedestrian crossing speed at signalized crosswalks

Road accidents are one of the main causes of child mortality, and research results show that children do not have an adequate perception of traffic risks and are prone to insecure and impulsive reactions in traffic situations. The data clearly show that educational and restrictive measures need to be complemented by engineering measures that shape pedestrian transport infrastructure (especially crosswalks) according to the needs of vulnerable traffic users. The influence of children's age, gender, group movement, supervision, distractions and the influence of traffic infrastructure has been widely studied.In articles previously published by the authors, on the basis of field research involving child pedestrians at zebra crosswalks in the vicinity of primary schools in two Croatian and one Italian city, several parameters were identified as significant for the development of the linear regression model for the speed of child pedestrians. Statistical analysis showed that the statistically significant parameters are related to the design of the conflict zone of the transport infrastructure, as well as traffic regulation. As the developed model is considered complex with regard to the number of parameters, a simplified model will be developed in the following of this article. In the first phase, a simplified model with exclusively infrastructural parameters will be developed that would allow a simple application in solving various engineering and planning problems in traffic infrastructure, and its accuracy will be tested. In subsequent phases, models including other main/simple parameters will be developed and tested and the models will be compared. The simplified models thus developed could be used in the early stages of planning by professionals to test or plan pedestrian traffic infrastructure or traffic signals in corridors that are regularly used by children on the basis of easily definable parameters - considering the infrastructure elements and basic data on children.

The ambivalence of independent mobility: Balancing perceived risks and expected benefits of walking to school in inner-city neighborhoods

Drawing on two Southern California neighborhoods, this paper assesses children’s perceptions of the risks of walking to school in urban and low-income communities of color, balanced against the expected benefits of child independent mobility. Quantitatively-estimated relationships between children’s travel modes and environmental observations show that those who walk to school – especially those who walk alone – exhibit heightened environmental perceptions at granular levels. They identify more negative aspects of the built environment (both social and physical) than those who are driven, suggesting they feel more vulnerable along their school routes. They also make more observations of the built environment in aggregate, suggesting that walking – an interactive mode of travel – confers greater spatial awareness. To maximize the psychological, cognitive, and social well-being benefits that child pedestrians can accrue from their experiences in inner-city settings, measures mitigating neighborhood risks are a necessary complement to existing traffic safety-oriented policies.

Child pedestrian, drowning and burn mortality in Johannesburg

The study examined the extent, demographics and risks for child pedestrian, burns and drowning mortality in Johannesburg. Information on the demographics, scene and temporal circumstances for childhood injury deaths from 2000 to 2010 was gleaned from the National Injury Mortality Surveillance System. Descriptive statistical methods were used. The study recorded 756 pedestrian (8.7/100,000), 439 drowning (5.1/100,000), and 399 burn injury deaths (4.6/100,000) among children aged 0–14 years. Male children were the main victims, with male-to-female ratios of 2.3 for drowning, 1.7 for pedestrian and 1.2 for burn mortality. The pattern of child mortality differed across age groups with older children recording higher rates for pedestrian deaths and younger children higher rates for the non-traffic deaths. Pedestrian and burn mortality especially affected black children, while drowning affected both black and white children. The time, day and month of greatest injury mortality varied by injury cause, with e.g. pedestrian mortality common in afternoons and evenings, weekends, and dispersed across the year although increasing towards year end. The study highlighted the salience of differentiating risks for childhood injuries by discrete external cause for purposes of informing prevention responses.

An Examination of Child Pedestrian Rule Compliance at Crosswalks around Parks in Montreal, Canada.

This study aims to examine child pedestrian safety around parks by considering four rule-compliance measures: temporal, spatial, velocity and visual search compliance. In this regard, street crossing observations of 731 children were recorded at 17 crosswalks around four parks in Montreal, Canada. Information on child behaviors, road features, and pedestrian-vehicle interactions were gathered in three separate forms. Chi-square tests were used to highlight the individual, situational, behavioral and road environmental characteristics that are associated with pedestrian rule compliance. About half of our sampled children started crossing at the same time as the adults who accompanied them, but more rule violations were observed when the adult initiated the crossing. The child's gender did not have a significant impact on rule compliance. Several variables were positively associated with rule compliance: stopping at the curb before crossing, close parental supervision, and pedestrian countdown signals. Pedestrian-car interaction had a mixed impact on rule compliance. Overall, rule compliance among children was high for each of our indicators, but about two-thirds failed to comply with all four indicators. A few measures, such as longer crossing signals and pedestrian countdown displays at traffic lights, may help to increase rule compliance and, ultimately, provide safer access to parks.