The role of the physical and traffic environment in child pedestrian injuries
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P F Agran1, D G Winn, C L Anderson
1Pediatric Injury Prevention Research Group, University of California, Irvine 92697-5800, USA.
Insights
Environmental factors like multifamily housing and street parking increase pediatric pedestrian injury risk. Reducing street parking and vehicle speed on busy residential streets can help prevent child injuries.
Area of Science:
- Environmental health
- Pedestrian safety
- Child injury prevention
Background:
- Pedestrian injuries are a significant cause of unintentional injury-related deaths and disabilities in children.
- Residential street environments contain numerous factors that may influence the risk of pedestrian injuries.
- Understanding these environmental risk factors is crucial for developing effective prevention strategies.
Purpose of the Study:
- To identify specific environmental risk factors on residential streets associated with pediatric pedestrian injuries.
- To inform targeted interventions aimed at reducing the incidence of child pedestrian injuries.
Main Methods:
- A case-control study design was employed, comparing 39 injured Latino children (pedestrian cases) with 62 matched neighborhood controls.
- Data were collected through neighborhood assessments conducted during peak pedestrian activity hours (3:45 PM to 5 PM).
- Conditional logistic regression analysis was used to estimate incidence rate ratios (IRRs) for various environmental factors.
Main Results:
- Children residing in multifamily residences had a significantly higher risk of pedestrian injury compared to those in single-family homes (IRR 3.1).
- High levels of street parking (over 50% curb occupancy) were strongly associated with increased injury risk (IRR 9.6).
- Increased vehicular speed was linked to a marked rise in injury risk, while higher traffic volume showed a protective association in the adjusted model.
Conclusions:
- Residential streets with a high proportion of multifamily housing, extensive street parking, and numerous pedestrians require priority for injury prevention programs.
- Interventions should focus on reducing street parking to improve visibility and decreasing vehicular speed to mitigate pedestrian injury risks.
- Targeted environmental modifications on high-risk streets are essential for enhancing child pedestrian safety.
Objective:
To identify environmental risk factors on residential streets for pediatric pedestrian injuries.
Method:
The sample consisted of 39 Latino children 0 to 14 years of age injured as pedestrians on a street in the same block as their home and 62 randomly selected neighborhood control subjects matched to the case by city, age or year of birth, ethnicity, and gender. The cases were identified from a population-based hospital and coroner's office surveillance system established in north-central Orange County, CA. Neighborhood assessments were performed from 3:45 PM to 5 PM, a fairly active time for young pedestrians. The cases were compared with the controls using conditional logistic regressions; in this study design, the odds ratios were interpreted as estimates of the incidence rate ratios.
Results:
Children living in a multifamily residence had an incidence of injury greater than that of children living in single-family residence on a single lot (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.3-7.6). The ORs in the highest category were several times those in the lowest category for both parked vehicles (OR 9.6, 95% CI 2.6-36) and total number of pedestrians observed (OR 4.7, 95% CI 1.4-16). Vehicle parking, total pedestrians, vehicular traffic volume, and speed were examined in a multivariate model. The association of vehicles parked on the street with pedestrian injury risk remained significant. Unlike the crude results, progressively greater vehicular speed was associated with a marked increase in risk. Progressively higher vehicular traffic volume was associated with a progressively lower adjusted OR.
Conclusion:
The results of this analysis would indicate that residential streets with a high proportion of multifamily residence, over 50% of the curb occupied with parked vehicles, and a large number of pedestrians observed in unenclosed areas should receive high priority for intervention programs to reduce pediatric pedestrian injuries. The analysis suggests that on these streets, measures to reduce the amount of street parking (thus increasing visibility) and reductions in vehicular speed should be considered to decrease pedestrian injuries.