Pedestrian Injury Risk Research Articles

Parental supervision and discomfort with children walking to school in low-income communities in Cape Town, South Africa

ABSTRACTObjective: The risk of pedestrian injury is compounded for children living in low-income communities due to factors such as poor road and pedestrian infrastructure, reliance on walking as a means of transport, and compromised supervision. Parents play an important role in child pedestrian safety. The primary objective of this study was to examine the effects of child pedestrian variables on parental discomfort with regard to letting their child walk to and from school and on the frequency of adult supervision.Methods: A cross-sectional study was conducted using a convenience sample from 3 schools participating in a pedestrian safety school initiative. The schools are situated in low-income, high-risk communities in the City of Cape Town. A parent survey form was translated into isiXhosa and sent home with learners to those parents who had consented to participate. The response rate was 70.4%, and only parents of children who walk to and from school were included in the final sample (n = 359). Child pedestrian variables include the time taken to walk to school, parental rating of the child's ability to safely cross the road, and the frequency of adult supervision.Results: More than half of parents reported that their child walked to and from school without adult supervision. About 56% of children took less than 20 min to walk to school. Most parents (61%) were uncomfortable with their child walking to school, although the majority of parents (55.7%) rated their child's ability to cross the road safely as better or significantly better than average (compared to peers). The parents did not perceive any differences in pedestrian risk factors between boys and girls or between younger (6–9 years) and older (10–15 years) children. The time spent by a child walking to school and parents' perceptions of their child's road-crossing ability were found to be significant predictors of parental discomfort (in letting their child walk). Younger children and children who spent less time walking were more likely to be supervised by an adult.Conclusions: Many South African schoolchildren have to navigate the roads without adult supervision from a young age. Caregivers, especially in low-income settings, often have limited options with regard to getting their child to school safely. Regardless of the child's age and gender, the time that they spend on the roads is an important factor for parents in terms of pedestrian safety.

Effects of passenger car front profile and human factors on pedestrian lower extremity injury risk using German in-depth accident data

ABSTRACTThis study aimed to identify the correlations of pedestrian with moderate to untreatable (AIS2+) lower extremity injury risk with the pedestrian kinematics and vehicle front profile variables using real-world accident data. A subsample of 404 pedestrian accident cases with lower extremity injuries was selected from German in-Depth Accident Study (GIDAS) database to conduct statistical analysis. Variance test and logistic regression analysis was performed to analyze associations between selected variables and risk of pedestrian with AIS2+ lower extremtiy injuries. The results revealed that the predicted variables of the impact speed, pedestrian age and weight, the Lower bumper height (LBH) and the Bonnet leading edge height (BLEH) were statistically significant for AIS2+ lower extremity injuries. The higher impact speed, the higher LBH and BLEH corresponded to a greater likelihood of suffering an AIS 2+ lower extremity injury. The results could provide background knowledge for improving pedestrain protective strategies in passenger vehicle design.

Development and Validation of an Age-Specific Lower Extremity Finite Element Model for Simulating Pedestrian Accidents.

The objective of the present study is to develop an age-specific lower extremity finite element model for pedestrian accident simulation. Finite element (FE) models have been used as a versatile tool to simulate and understand the pedestrian injury mechanisms and assess injury risk during crashes. However, current computational models only represent certain ages in the population, the age spectrum of the pedestrian victims is very large, and the geometry of anatomical structures and material property of the lower extremities changes with age for adults, which could affect the injury tolerance, especially in at-risk populations such as the elderly. The effects of age on the material mechanical property of bone and soft tissues of the lower extremities as well as the geometry of the long bone were studied. Then an existing 50th percentile male pedestrian lower extremity model was rebuilt to depict lower extremity morphology for 30- to 70-year-old (YO) individuals. A series of PMHS tests were simulated to validate the biofidelity and stability of the created age-specific models and evaluate the lower extremity response. The development of age-specific lower extremity models will lead to an improved understanding of the pedestrian lower extremity injury mechanisms and injury risk prediction for the whole population in vehicle-pedestrian collision accidents.

An overview on pedestrians involved in traffic accidents in Latvia: Years 2010-2014

Latvian national road accident statistics shows that for the vulnerable road users’ situation is critical, since pedestrians are involved in more than a quarter of road traffic accidents. This paper gives an analysis on pedestrians involved in road traffic accidents based on the road safety accident database in Latvia for the years 2010–2014. The total number of cases does not change significantly, however there has been an increase in pedestrian fatality rates over the period. From the total number of traffic accidents with pedestrians involved 92.4% had injuries, 6.8% were lethal cases and others didn't suffer from injuries. Out of 342 fatalities 37.7% occurred during the winter period, 56.1% in adverse weather (overcast, fog, rain or snow), 69.9% during twilight or darkness and 26.9% on weekends. Out of all accidents 55.3% occurred in the capital city Riga, but fatality rate was higher on main state roads. 8.1% of the total number of pedestrians involved in road traffic accidents was found to have alcohol in their blood right after the road traffic accident. Fatality rate was higher for those with exceeded BAC. Pedestrian injury risk analysis was associated with demographical and traffic-related factors, urbanization, visibility and seasonal patterns.

Analysis of pedestrian-to-ground impact injury risk in vehicle-to-pedestrian collisions based on rotation angles

IntroductionDue to the diversity of pedestrian-to-ground impact (secondary impact) mechanisms, secondary impacts always result in more unpredictable injuries as compared to the vehicle-to-pedestrian collisions (primary impact). The purpose of this study is to investigate the effects of vehicle frontal structure, vehicle impact velocity, and pedestrian size and gait on pedestrian-to-ground impact injury risk. MethodA total of 600 simulations were performed using the MADYMO multi-body system and four different sizes of pedestrians and six types initial gait were considered and impacted by five vehicle types at five impact velocities, respectively. The pedestrian rotation angle ranges (PRARs) (a, b, c, d) were defined to identify and classify the pedestrian rotation angles during the ground impact. ResultsThe PRARs a, b, and c were the ranges primarily observed during the pedestrian landing. The PRAR has a significant influence on pedestrian-to-ground impact injuries. However, there was no correlation between the vehicle velocity and head injury criterion (HIC) caused by the secondary impact. In low velocity collisions (20, 30km/h), the severity of pedestrian head injury risk caused by the secondary impact was higher than that resulting from the primary impact. ConclusionsThe PRARs defined in this study are highly correlated with the pedestrian-to-ground impact mechanism, and can be used to further analyze the pedestrian secondary impact and to predict the head injury risk. Practical applicationsTo reduce the pedestrian secondary impact injury risk, passive and active safety countermeasures should be considered together to prevent the pedestrian's head-to-ground impacts, particularly in the low-velocity collisions.

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.

Sleep behaviors in traditional-age college students: A state of the science review with implications for practice.

The purpose of this systematic review was to examine influences affecting sleep behavior in traditional-age college students and to advocate for improved sleep behavior assessments. A literature search of CINAHL, MEDLINE, and PubMed databases was performed using the search terms "college students" and "sleep" in the title that were published in English from 1978 to 2016. The circadian clock is reset in traditional-age college students leading to delayed sleep times. Newly realized autonomy and increased use of technology also prevent traditional-age college students from obtaining sufficient sleep. Insufficient sleep experienced by these students has been linked to insulin resistance, hypertension, diabetes, weight gain, and stress. Sleep insufficiency increases the risk for pedestrian, motor vehicle, and domestic and occupational injuries. Insufficient sleep may result in poor academic performance influencing subsequent health outcomes. Evidence supports the need for nurse practitioners and other healthcare providers to incorporate systematic sleep behavior assessments to improve health outcomes among traditional-age college students.

Pedestrian lower extremity injury risk in car-pedestrian collisions

Here, the pedestrian lower extremity injury risk was studied using the real world accident data. For this purpose, 354 cases with pedestrian lower extremity injuries selected from the german in-depth accident study(GIDAS) database were used to conduct the one-way variance analysis to determine the effects of impact speed, pedestrian age, height and weight on the pedestrian serious lower extremity injuries risk. Then, the pedestrian serious lower extremity injury risk model was established. The results showed that the impact speed and pedestrian age are significant factors affecting pedestrian lower extremity serious injuries, but the pedestrian weight and height are not; the risk of injury is positively related to impact speed and pedestrian age; the pedestrian serious lower extremity injury risk reaches 50% when the impact speed is 43 km/h.

Distracted Pedestrian Behavior on two Urban College Campuses.

Pedestrian injuries injure about 180,000 individuals and kill 6000 each year in the United States, and pedestrian injury rates have increased each of the last several years. Distracted pedestrian behavior may play a role in the trend of increasing risk for pedestrian injury. Using in vivo behavioral coding over the course of twoweeks on two urban college campuses, this study aimed to (1) understand the type and rate of distractions engaged in by pedestrians on urban college campuses, and (2) investigate the impact of distraction on street-crossing safety and behavior. A total of 10,543 pedestrians were observed, 90% of them young adults. Over one-third of those pedestrians were distracted while actively crossing roadways. Headphones were the most common distraction (19% of all pedestrians), followed by text-messaging (8%) and talking on the phone (5%). Women were more likely to text and talk on the phone than men, and men were more likely to be wearing headphones. Distracted pedestrians were somewhat less likely to look for traffic when they entered roadways. As handheld device usage continues to increase, behavioral interventions should be developed and implemented. Changes to policy concerning distracted pedestrian behavior, including improvement of the built environment to reduce pedestrian risk, should be considered in busy pedestrian areas like urban college campuses.

Examining how different measurement approaches impact safety outcomes in child pedestrian research: Implications for research and prevention

There has been a great deal of research aimed at understanding the causes of child pedestrian injury. Many different methods have been employed with the goal of designing simulations that produce rigorous assessment of children’s behaviors without putting children at risk of actual pedestrian injury. Most research has assessed children’s pre-crossing decision making and extrapolated crossing outcome measures from estimates of mean walking speed. This study explores the nature and extent of measurement bias that is introduced when average walking speed is used to produce estimates of outcomes versus measuring actual in-road behavior directly. Using a within-subjects design and a fully immersive virtual reality pedestrian simulator, both measures were taken. Comparisons based on regression models revealed the extent of differences in results produced by measurement bias. Results indicated that measurement bias is produced when average walking speed is used such that hits and high risk crossings are overestimated and missed opportunities are underestimated, resulting in an overall overestimate of children’s risk for pedestrian injury. The discussion highlights how these two measurement approaches emphasize different underlying processes as determinants of child pedestrian injury risk.

Detection of the toughest: Pedestrian injury risk as a smooth function of age

ABSTRACTObjective: Though it is common to refer to age-specific groups (e.g., children, adults, elderly), smooth trends conditional on age are mainly ignored in the literature. The present study examines the pedestrian injury risk in full-frontal pedestrian-to–passenger car accidents and incorporates age—in addition to collision speed and injury severity—as a plug-in parameter.Methods: Recent work introduced a model for pedestrian injury risk functions using explicit formulae with easily interpretable model parameters. This model is expanded by pedestrian age as another model parameter. Using the German In-Depth Accident Study (GIDAS) to obtain age-specific risk proportions, the model parameters are fitted to the raw data and then smoothed by broken-line regression.Results: The approach supplies explicit probabilities for pedestrian injury risk conditional on pedestrian age, collision speed, and injury severity under investigation. All results yield consistency to each other in the sense that risks for more severe injuries are less probable than those for less severe injuries. As a side product, the approach indicates specific ages at which the risk behavior fundamentally changes. These threshold values can be interpreted as the most robust ages for pedestrians.Conclusions: The obtained age-wise risk functions can be aggregated and adapted to any population. The presented approach is formulated in such general terms that in can be directly used for other data sets or additional parameters; for example, the pedestrian's sex. Thus far, no other study using age as a plug-in parameter can be found.

The influence of passenger car front shape on pedestrian injury risk observed from German in-depth accident data

Quantified relationships between passenger car front shape and pedestrian injury risk derived from accident data are sparse, especially considering the significant recent changes in car front design. The purpose of this paper is therefore to investigate the detailed effects of passenger car front shape on injury risk to a pedestrian’s head, thorax, pelvis and leg in the event of a vehicle pedestrian impact. Firstly, an accident sample of 594 pedestrian cases captured during 2000–2015 from the German In-Depth Accident Study (GIDAS) database was employed. Multicollinearity diagnostic statistics were then used to detect multicollinearity between the predictors. Following this, logistic regression was applied to quantify the effects of passenger car front shape on injury risks while controlling for impact speed and pedestrian age. Results indicate that the bumper lower depth (BLD), bumper lower height (BLH), bumper upper height (BUH) and normalised bumper lower/upper height (NBLH/NBUH) are statistically significant for AIS2+ leg injury risk. The normalised bonnet leading edge height (NBLEH) has a statistically significant influence on AIS2+ femur/pelvis injury occurrence. The passenger car front shape did not show statistical significance for AIS3+ thorax and head injuries. The impact speed and pedestrian age are generally significant factors influencing AIS2+ leg and pelvis injuries, and AIS3+ thorax and head injuries. However, when head impacts are fixed on the central windscreen region both pedestrian age and impact speed are not statistically significant for AIS3+ head injury. For quantified effects, when controlling for speed, age and BUH, an average 7% and 6% increase in AIS2+ leg injury odds was observed for every 1cm increase in BLD and BLH respectively; 1cm increase in BUH results in a 7% decrease in AIS2+ leg injury odds when the BLD or BLH are fixed respectively (again controlling for impact speed and pedestrian age); the average AIS2+ femur/pelvis injury odds increase by 74% for a 10% increase in NBLEH. These findings suggest that passenger car bumpers should support the lower leg with a low and flat lower bumper and even contact up to the femur area with a high upper bumper which extends above the knee to protect the pedestrian’s leg. A low passenger car bonnet leading edge helps to reduce femur/pelvis injury risk. The passenger car front shape parameters are less influential than impact speed and pedestrian age for pedestrian injury risk.

Safer passenger car front shapes for pedestrians: A computational approach to reduce overall pedestrian injury risk in realistic impact scenarios

Vehicle front shape has a significant influence on pedestrian injuries and the optimal design for overall pedestrian protection remains an elusive goal, especially considering the variability of vehicle-to-pedestrian accident scenarios. Therefore this study aims to develop and evaluate an efficient framework for vehicle front shape optimization for pedestrian protection accounting for the broad range of real world impact scenarios and their distributions in recent accident data. Firstly, a framework for vehicle front shape optimization for pedestrian protection was developed based on coupling of multi-body simulations and a genetic algorithm. This framework was then applied for optimizing passenger car front shape for pedestrian protection, and its predictions were evaluated using accident data and kinematic analyses. The results indicate that the optimization shows a good convergence and predictions of the optimization framework are corroborated when compared to the available accident data, and the optimization framework can distinguish ‘good’ and ‘poor’ vehicle front shapes for pedestrian safety. Thus, it is feasible and reliable to use the optimization framework for vehicle front shape optimization for reducing overall pedestrian injury risk. The results also show the importance of considering the broad range of impact scenarios in vehicle front shape optimization. A safe passenger car for overall pedestrian protection should have a wide and flat bumper (covering pedestrians’ legs from the lower leg up to the shaft of the upper leg with generally even contacts), a bonnet leading edge height around 750mm, a short bonnet (<800mm) with a shallow or steep angle (either >17° or <12°) and a shallow windscreen (≤30°). Sensitivity studies based on simulations at the population level indicate that the demands for a safe passenger car front shape for head and leg protection are generally consistent, but partially conflict with pelvis protection. In particular, both head and leg injury risk increase with increasing bumper lower height and depth, and decrease with increasing bonnet leading edge height, while pelvis injury risk increases with increasing bonnet leading edge height. However, the effects of bonnet leading edge height and windscreen design on head injury risk are complex and require further analysis.

Changing the Future?: Development and Application of Pedestrian Safety Performance Functions to Prioritize Locations in Seattle, Washington

This study aimed to use robust analysis methods to identify and screen locations at risk for pedestrian crashes and injuries to help Seattle, Washington, a Vision Zero city, broaden treatment priorities beyond only high-crash locations. For this objective, data from the entire network were used to develop safety performance functions (SPFs) for two pedestrian crash types: total pedestrian crashes at intersections (a high frequency type) and a subset of intersection crashes involving through motorists striking crossing pedestrians (a high severity type). Many variables from roadway, built environment, census, and activity measures were tested. A similar but not identical set of variables, including measures of activity and intersection size and complexity, significantly contributed to crash prediction in both models. Pedestrian volume exhibited a curved relationship to crashes and demonstrated a tendency for expected crashes to begin to decline above a threshold value; however, the causes of this relationship were unknown. The SPFs were used in several ranking methods, including SPF-predicted crashes, empirical Bayes estimated crashes, and potential for safety improvement, to aid in prioritization of locations that might have been candidates for safety improvement but that had not necessarily experienced a high frequency of crashes. On the basis of this example, this approach is feasible for jurisdictions that wish to be more proactive in addressing potential crashes and injuries. Jurisdictions must, however, begin routinely collecting the data needed to implement the method efficiently.

Child pedestrian safety knowledge, behaviour and road injury in Cape Town, South Africa

Pedestrian injuries are a leading cause of death among South African children, and young children residing in low-income communities are more at risk, due to various factors such as inadequate road infrastructure, exposure to traffic due to reliance on walking as a means of transport, and lack of supervision. This study used a cross-sectional, non-randomized self-report survey to assess pedestrian safety knowledge, road-crossing behaviour and pedestrian injuries of primary school children in selected low-income settings in Cape Town. The survey focused on three primary schools that had joined the Safe Kids Worldwide Model School Zone Project and was administered to 536 children aged 6–15 years, in their home language of isiXhosa. Descriptive and bivariate analyses as well as multivariate regression analyses were conducted to investigate potential predictor variables for pedestrian collision severity and unsafe road-crossing behaviour. Walking was the sole form of travel for 81% of the children, with a large proportion regularly walking unsupervised. Children who walk to or from school alone were younger and reported riskier road-crossing behaviour, although children who walk accompanied tended to have higher pedestrian collision severity. “Negligent Behaviour” related to road-crossing was significantly associated with higher pedestrian collision severity, with predictors of “Negligent Behaviour” including the lack of pedestrian safety knowledge and greater exposure to traffic in terms of time spent walking. More than half of the reported pedestrian collisions involved a bicycle, and older boys (10–15 years) were most at risk of experiencing a severe pedestrian injury. The findings substantiate emerging evidence that children in low-income settings are at greater risk for child pedestrian injury, and emphasise the need for evidence-based safety promotion and injury prevention interventions in these settings.

Improving safety of vulnerable road users: Effectiveness of environment and in-vehicle warning systems at intermodal interchanges

ABSTRACTIn certain environments pedestrians are at an increased risk for pedestrian-vehicle crashes. Sites such as bus terminals, where there is an increase in foot traffic, create a higher risk for pedestrian injuries and fatalities. The current study investigates the effectiveness of structural and in-vehicle interventions for modifying driver behavior as drivers approach, pass through, and depart from an urban bus terminal. The impact of facility structural elements (pedestrian crossing signs, marked crosswalks, and sidewalks) and an in-vehicle pedestrian warning system was evaluated using the Center for Advanced Vehicular Systems driving simulator. Thirty-seven participants completed an urban driving task in a high-fidelity driving simulator. Driver speed and lane position were evaluated. An in-vehicle alarm indicating “high pedestrian areas” led to reduced driver speed, but drivers shifted closer to the shoulder (and pedestrians). Marked crosswalks had no observed effect on driver speed or vehicle controls but also led to drivers positioning themselves closer to the shoulder. Drivers exhibited risk-compensation behaviors by driving faster and closer to shoulders when sidewalks were present. Pedestrian crossing signals led to reduced driver speed. The authors recommend the placement of signed crosswalks mid-street where there is high pedestrian traffic.

National Safe Routes to School program and risk of school-age pedestrian and bicyclist injury

PurposeSafe Routes to School (SRTS) was a federally funded transportation program for facilitating physically active commuting to and from school in children through improvements of the built environment. There is evidence that SRTS programs increase walking and bicycling in school-age children, but their impact on pedestrian and bicyclist safety has not been adequately examined. We investigate the impact and effects of the SRTS program on school-age pedestrian and bicyclist injuries in a nationwide sample in the United States. MethodsData were crash records for school-age children (5–19 years) and adults (30–64 years), in 18 U.S. states for a 16-year period (1995–2010). Multilevel negative binomial models were used to examine the association between SRTS intervention and the risk of pedestrian and bicyclist injury in children aged 5–19 years. ResultsSRTS was associated with an approximately 23% reduction (incidence rate ratio = 0.77, 95% confidence interval = 0.65–0.92) in pedestrian/bicyclist injury risk and a 20% reduction in pedestrian/bicyclist fatality risk (incidence rate ratio = 0.80, 95% confidence interval = 0.68–0.94) in school-age children compared to adults aged 30–64 years. ConclusionsImplementation of the SRTS program appears to have contributed to improving traffic safety for school-age children in the United States.

Spatial analysis of the association of alcohol outlets and alcohol-related pedestrian/bicyclist injuries in New York City.

BackgroundPedestrian and bicyclist injury is an important public health issue. The retail environment, particularly the presence of alcohol outlets, may contribute the the risk of pedestrian or bicyclist injury, but this association is poorly understood.MethodsThis study quantifies the spatial risk of alcohol-related pedestrian injury in New York City at the census tract level over a recent 10-year period using a Bayesian hierarchical spatial regression model with Integrated Nested Laplace approximations. The analysis measures local risk, and estimates the association between the presence of alcohol outlets in a census tract and alcohol-involved pedestrian/bicyclist injury after controlling for social, economic and traffic-related variables.ResultsHolding all other covariates to zero and adjusting for both random and spatial variation, the presence of at least one alcohol outlet in a census tract increased the risk of a pedestrian or bicyclist being struck by a car by 47 % (IDR = 1.47, 95 % Credible Interval (CrI) 1.13, 1.91).ConclusionsThe presence of one or more alcohol outlets in a census tract in an urban environment increases the risk of bicyclist/pedestrian injury in important and meaningful ways. Identifying areas of increased risk due to alcohol allows the targeting of interventions to prevent and control alcohol-related pedestrian and bicyclist injuries.

Accidents involving pedestrians with their backs to traffic or facing traffic: an evaluation of crash characteristics and injuries

SummaryThis paper examines pedestrian anatomical injuries and crash characteristics in back‐to‐traffic and facing‐traffic crashes. Pedestrian crashes involving pedestrians walking along streets (i.e. with their backs to traffic or facing traffic) have been overlooked in literature. Although this is not the most frequent type of crash, the crash consequence to pedestrians is a safety concern. Combining Taiwan A1A2 police‐reported accident data and data from the National Health Insurance Database from years 2003–2013, this paper examines anatomical injuries and crash characteristics in back‐to‐traffic and facing‐traffic crashes. There were a total of 830 and 2267 pedestrian casualties in back‐to‐traffic and facing‐traffic crashes respectively. The injuries sustained by pedestrians and crash characteristics of these two crash types were compared with those of other crossing types of crashes (nearside crash, nearside dart‐out crash, offside crash, and offside dart‐out crash). Odds of various injuries to body regions were estimated using logistic regressions. Key findings include that the percentage of fatalities in back‐to‐traffic crashes is the highest; logistic models reveal that pedestrians in back‐to‐traffic crashes sustained more head, neck, and spinal injuries than did pedestrians in other crash types, and unlit darkness and non‐built‐up roadways were associated with an increased risk of pedestrian head injuries. Several crash features (e.g. unlit darkness, overtaking manoeuvres, phone use by pedestrians and drivers, and intoxicated drivers) are more frequently evident in back‐to‐traffic crashes than in other types of crashes. The current research suggests that in terms of crash consequence, facing traffic is safer than back to traffic. Copyright © 2016 John Wiley &amp; Sons, Ltd.

The role of Body Mass Index in child pedestrian injury risk

The goal of the current investigation was to examine obesity as a potential risk factor for childhood pedestrian injury. A racially diverse sample of 7- and 8-year-old children completed a road-crossing task in a semi-immersive virtual environment and two pedestrian route selection tasks. Multiple linear regression analyses revealed that children with a higher Body Mass Index (BMI) waited less before crossing, had a smaller temporal buffer between themselves and oncoming traffic while crossing, and had more collisions with traffic. Girls were more cautious than boys when crossing the virtual roadway. Unlike the results from the virtual road-crossing task, BMI was not associated with risky route selection. Instead, race emerged as the strongest predictor, with African–American children selecting riskier routes for crossing. Together, these findings suggest overweight and obese children may be at increased risk for pedestrian injury. The discussion considers explanations for why obese children may exhibit riskier road-crossing behavior.