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ORIGINAL ARTICLE |
1 Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia
2 Departments of Pediatrics and Biostatistics and Epidemiology, Children’s Hospital of Philadelphia and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia
3 Department of Pediatrics, Children’s Hospital of Philadelphia and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia
Correspondence to:
Dr Jill C Posner, Division of Emergency Medicine, Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA;
posner{at}email.chop.edu
Objectives: To explore the immediate pre-crash activities and the routine traffic exposure (street crossing and play) in a sample of urban children struck by automobiles. In particular, the traffic exposure of children who were struck while playing was compared with that of those struck while crossing streets.
Design: Cross sectional survey.
Setting: Urban pediatric emergency department.
Patients: A total of 139 children ages 4–15 years evaluated for acute injuries resulting from pedestrian-motor vehicle collisions during a 14 month period.
Main outcome measures: Sites of outdoor play, daily time in outdoor play, weekly number of street crossings, pre-crash circumstance (play v walking).
Results: Altogether 39% of the children routinely used the street and 64% routinely used the sidewalks as play areas. The median number of street crossings per week per child was 27. There were no differences in exposures for the 29% who were hit while playing compared with the 71% who were hit while walking. Although 84% of the children walked to or from school at least one day per week, only 15% of the children were struck while on the school walking trip. The remainder were injured either while playing outdoors or while walking to other places.
Conclusions: Urban children who are victims of pedestrian crashes have a high level of traffic exposure from a variety of circumstances related to their routine outdoor playing and street crossing activities. The distributions of traffic exposures were similar across the sample, indicating that the sample as a whole had high traffic exposure, regardless of the children’s activity preceding the crash. Future pedestrian injury programs should address the pervasive nature of children’s exposure to traffic during their routine outdoor activities.
Keywords: traffic; exposure
Abbreviations: AIS, abbreviated injury scale; CI, confidence interval; MAIS, maximum AIS
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