Pedestrian-motor Vehicle Collisions Research Articles

A National Study on the Comparative Burden of Pedestrian Injuries from Falls Relative to Pedestrian Injuries from Motor Vehicle Collisions.

Pedestrian injuries from falls are an understudied cause of morbidity. Here, we compare the burden of pedestrian injuries from falls occurring on streets and sidewalks with that from motor vehicle collisions. Data on injurious falls on streets and sidewalks, and pedestrian-motor vehicle collisions, to which Emergency Medical Services responded, along with pedestrian and incident characteristics, were identified in the 2019 National Emergency Medical Services Information System database. In total, 118,520 injurious pedestrian falls and 33,915 pedestrians-motor vehicle collisions were identified, with 89% of the incidents occurring in urban areas. Thirty-two percent of pedestrians struck by motor vehicles were coded as Emergent or Critical by Emergency Medical Services, while 19% of pedestrians injured by falls were similarly coded. However, the number of pedestrians whose acuity was coded as Emergent or Critical was 2.1 times as high for injurious falls as compared with pedestrians-motor vehicle collisions. This ratio was 3.9 for individuals 50years and older and 6.1 for those 65years and older. In conclusion, there has been substantial and appropriate policy attention given to preventing pedestrian injuries from motor vehicles, but disproportionately little to pedestrian falls. However, the population burden of injurious pedestrian falls is significantly greater and justifies an increased focus on outdoor falls prevention, in addition to urban design, policy, and built environment interventions to reduce injurious falls on streets and sidewalks, than currently exists across the USA.

Trends in child pedestrian motor vehicle collision injury rates by neighborhood deprivation score in Toronto, Canada

We examined trends from 2000 to 2019 in child pedestrian motor vehicle collision (PMVC) injury rates in Toronto, Canada, to see if injury trends varied by neighbourhood deprivation. This 20-year period was associated with major road safety policy changes in the City. A Poisson regression analysis examined police-reported data on children (age 1–19 years), killed or seriously injured (KSI) PMVC rates, by deprivation status (using the Ontario Marginalization Index), over the period 2000–2019. Models controlled for location (urban core v. inner suburbs) and evaluated potential interactions. There were 523 child pedestrian KSI collisions from 2000 to 2019. Over this period, KSI rates decreased by more than 50 % across all neighbourhood deprivation levels. Steep declines from 2000 to 2010 were followed by level or increasing child PMVC rates from 2010 to 2019. Higher deprivation was associated with slightly elevated KSI rates; although not statistically significant. It is important to learn from road safety policy “successes” and ensure that future road safety interventions are applied equitably across areas, accounting for deprivation and location.

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.

Disability and pedestrian road traffic injury: A scoping review.

Disability and ableism remain a nascent area of inquiry in road traffic injury research. A scoping review of academic literature was conducted to understand the state of knowledge on disability and pedestrian-motor vehicle collisions. Sixty-two eligible articles were identified and included. A significantly higher risk of pedestrian collisions, injuries, and fatalities was consistently found among disabled people. Risk factors included individualized factors such as walking speed and crossing decisions of disabled people. The roles of social/political environments in injury risk were less commonly explored. More research is needed to assess how inaccessible or disabling environments may produce elevated risk of pedestrian injury among disabled populations.

Child pedestrian and cyclist injuries, and the built and social environment across Canadian cities: the Child Active Transportation Safety and the Environment Study (CHASE)

IntroductionTraffic injury is a leading and preventable cause of child death and disability, with child pedestrians and cyclists particularly vulnerable. Examining built environment correlates of child pedestrian and cyclist motor...

Evidence-based traffic engineering measures to reduce pedestrian motor vehicle collisions: A review

Evidence-based traffic engineering measures to reduce pedestrian motor vehicle collisions: A review

Effect of reducing the posted speed limit to 30 km per hour on pedestrian motor vehicle collisions in Toronto, Canada - a quasi experimental, pre-post study

BackgroundPedestrian related deaths have recently been on the rise in Canada. The effect of changing posted speeds on the frequency and severity of pedestrian motor vehicle collisions (PMVC) is not well studied using controlled quasi-experimental designs. The objective of this study was to examine the effect of lowering speed limits from 40 km/h to 30 km/h on PMVC on local roads in Toronto, Canada.MethodsA 30 km/h speed limit on local roads in Toronto was implemented between January 2015 and December 2016. Streets that remained at a 40 km/h speed limit throughout the study period were selected as comparators. A quasi-experimental, pre-post study with a comparator group was used to evaluate the effect of the intervention on PMVC rates before and after the speed limit change using repeated measures Poisson regression. PMVC data were obtained from police reports for a minimum of two years pre- and post-intervention (2013 to 2018).ResultsSpeed limit reductions from 40 km/h to 30 km/h were associated with a 28% decrease in the PMVC incidence rate in the City of Toronto (IRR = 0.72, 95% CI: 0.58–0.89). A non-significant 7% decrease in PMVC incidence rates were observed on comparator streets that remained at 40 km/h speed limits (IRR = 0.93, 95% CI: 0.70–1.25). Speed limit reduction also influenced injury severity, with a significant 67% decrease in major and fatal injuries in the post intervention period on streets with speed limit reductions (IRR = 0.33, 95% CI: 0.13–0.85) compared with a 31% not statistically significant decrease in major and fatal injuries on comparator streets (IRR = 0.69, 95% CI: 0.37–1.31). The interaction term for group and pre-post comparisons was not statistically significant (p = 0.14) indicating that there was no evidence to suggest a pre-post difference in IRRs between the intervention and comparator streets.ConclusionsDeclines in the rate of PMVC were observed on roads with posted speed limit reductions from 40 km/h to 30 km/h, although this effect was not statistically greater than reductions on comparator streets.

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.

The built environment and active transportation safety in children and youth: a study protocol

BackgroundActive transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury.MethodsFirst, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist’s route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries.DiscussionThis program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team’s national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.

Factors related to road system organisation and its association with mortality due to motor vehicle-pedestrian collisions in Guadalajara Metropolitan Area

IntroductionTraffic events are one of the five leading causes of mortality in Mexico. Pedestrians are one of the main road users involved in such incidents and have the highest mortality...

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,...

Epidemiology of Pedestrian–Motor Vehicle Fatalities and Injuries, 2006–2015

Pedestrian road safety remains a public health priority. The objective of this study is to describe trends in fatalities and injuries after pedestrian-motor vehicle collisions in the U.S. and identify associated risk factors for pedestrian fatalities. This is a cross-sectional study of U.S. pedestrian-motor vehicle collisions from 2006 to 2015 (performed in 2017). Pedestrian fatality and injury data were obtained from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System and National Automotive Sampling System General Estimates System. Frequencies of fatalities, injuries, and associated characteristics were calculated. Multivariable logistic regression was performed for risk of fatality, controlling for demographic and crash-related factors. There were 47,789 pedestrian fatalities and 674,414 injuries during the 10-year study period. Fatality rates were highest among the elderly aged 85 years and older (2.95/100,000 population), whereas injury rates were highest for those aged 15-19 years (35.23/100,000 population). Predictors associated with increased risk for death include the following: male sex (AOR=1.36, 95% CI=1.15, 1.62), age ≥65 years (AOR=3.44, 95% CI=2.62, 4.50), alcohol involvement (AOR=2.63, 95% CI=1.88, 3.67), collisions after midnight (AOR=5.21, 95% CI=3.20, 8.49), at non-intersections (AOR=2.76, 95% CI=2.21, 3.45), and involving trucks (AOR=2.15, 95% CI=1.16, 3.97) and buses (AOR=5.82, 95% CI=3.67, 9.21). Potentially modifiable factors are associated with increased risk of death after pedestrian-motor vehicle collisions. Interventions including elder-friendly intersections and increasing visibility of pedestrians may aid in decreasing pedestrian injuries and deaths.

A geography of child and elderly pedestrian injury in the City of Toronto, Canada

Walking is one of the most accessible forms of physical activity for people of all ages. Promoting increased walking for transport may contribute to reduced air pollution, noise and traffic congestion. Understanding the geography of pedestrian motor vehicle collisions (PMVCs) can provide evidence to inform policy and planning that targets increased walking while reducing pedestrian injury risk, however age-related differences in the geography of injury are expected given differences in activity patterns and physical and cognitive abilities. The purpose of this paper is to explore spatial patterns of pedestrian motor vehicle collisions (PMVCs) by age, injury severity, and location in Canada's largest city, the City of Toronto. Geographical variation in PMVCs and injuries by age (namely seniors and children) and severity were explored using indirect standardized rates. Moran's I statistics were estimated to study the spatial clustering of PMVCs across urban and inner suburban neighbourhoods. Distinct spatial patterns of PMVCs and injuries were evident among children and seniors. While evidence of spatial clustering was indicated for both age groups, children's injuries revealed the strongest clustering, while PMVCs involving seniors were more dispersed. Furthermore, fatal and major injury events appeared to be concentrated toward and within Toronto's inner suburbs for both age groups. Findings from this study demonstrate the importance of planning pedestrian safety interventions that acknowledge spatial differences in geographic patterns of PMVCs by age.

Spatial distribution of pedestrian-motor vehicle collisions before and after pedestrian countdown signal installation in Toronto, Canada

BackgroundPedestrian countdown signals (PCS) have been installed in many cities over the last 15 years. Few studies have evaluated the effectiveness of PCS on pedestrian motor vehicle collisions (PMVC). This...

Risk on the Road: Build Environment Effect on Severity of Injury in Pediatric Pedestrian or Bicyclist vs Motor Vehicle Collisions

Risk on the Road: Build Environment Effect on Severity of Injury in Pediatric Pedestrian or Bicyclist vs Motor Vehicle Collisions

The Relationship Between Objectively Measured Walking and Risk of Pedestrian-Motor Vehicle Collision.

Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian-motor vehicle collision is unknown. We examined associations between individuals' walking bouts and walking risk, measured as mean exposure to the risk of pedestrian-vehicle collision. Walking bouts were ascertained through integrated accelerometry and global positioning system data and from individual travel-diary data obtained from adults in the Travel Assessment and Community Study (King County, Washington) in 2008-2009. Walking patterns were superimposed onto maps of the historical probabilities of pedestrian-vehicle collisions for intersections and midblock segments within Seattle, Washington. Mean risk of pedestrian-vehicle collision in specific walking locations was assessed according to walking exposure (duration, distance, and intensity) and participant demographic characteristics in linear mixed models. Participants typically walked in areas with low pedestrian collision risk when walking for recreation, walking at a faster pace, or taking longer-duration walks. Mean daily walking duration and distance were not associated with collision risk. Males walked in areas with higher collision risk compared with females, while vehicle owners, residents of single-family homes, and parents of young children walked in areas with lower collision risk. These findings may suggest that pedestrians moderate collision risk by using lower-risk routes.

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.

A prediction model for pedestrian fatalities based on explanatory factors

A study of injury severity in pedestrian accidents can help to identify the number of fatalities as a result of motor vehicle-pedestrian collisions associated with different factors. The objective of this research is to develop statistical predictive model for pedestrian fatalities at the Dhaka metropolitan, capital of Bangladesh. This research focuses on the severity of accidents i.e. number of fatalities rather than accidents number, because number of fatalities shows the actual horror of the accidents. The model relates number of fatalities with the best set of explanatory factors as independent variables. With this objective in perspective, the research selects some possible factors as independent variables according to ARF (accident record form) of police that may contribute to road traffic accident fatalities. The independent variables in the modeling included factors such as- junction type, divider, roadway geometry, pedestrian location etc. To represent the non-linear relationship of fatalities with independent variables, Poisson regression model have been used. Therefore, delineation and subsequent improvement of these factors can improve the traffic safety at a given location.

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