The spatial and temporal dimensions of child pedestrian injury in Edmonton

Exploring associations between built environment and crash risk of children in school commuting

Understanding how built environment are associated with crash risk (CR) in school commuting is essential to improving travel safety through land use and transportation policies. Scholars often assume that this relationship is consistent across space, but this may lead to inconsistent estimates. To address this issue, using data in Shenzhen, China, the data covers traffic accident data of children taken from police incident reports and supplemented with local land use, transportation network and specific school information. The measurement model of crash scale was conducted to represent crash severity, and the CR was further quantified. The study applies three models, spatial dubin model (SDM), geographically weighted regression (GWR), and mixed GWR (MGWR), to explore spatio-temporal heterogeneity relationships between built environment attributes and CR of children in school commuting. The findings reveal that the crash scale can better represent crash severity of school commuting than a single indicator. Policy interventions should be targeted at specific spatial scales, school types, and time windows to effectively improve travel safety. However, there are some common findings. It is recommended to use a scale of 200 m to explain the relationship between the variables. The MGWR model outperforms the other two models. To reduce CR, it is important to consider lower road network density, a reasonable layout of educational facilities, fewer bus routes, and more on-street parking spaces. Our findings can help to enrich the understanding of associations between land use and CR of children, as well as offer local planning and operating guidance for creating child-friendly environment.

Objective and Perceived Traffic Safety for Children: A Systematic Literature Review of Traffic and Built Environment Characteristics Related to Safe Travel

The literature on children’s active transportation has shown the influence of the built environment characteristics on walking and crashes. Various reviews have examined those two questions. One influence on walking is the perception of traffic safety. However, it is not clear how, or even if, the built environment affects such perceptions. This research aims to understand which traffic and built environment characteristics influence objective and subjective/perceived traffic safety for children based on the analysis of previous studies in the field. Two types of research were used: the first examines the association between traffic and built environment characteristics and child pedestrian and/or cyclist collisions/injuries; the second relates to the perception of safety by parents and children for active transportation and, where studied, its relationship with built environment characteristics. A systematic review was conducted using five electronic databases. The total number of articles retrieved was reduced to 38 following the eligibility criteria and quality assessment, where 25 articles relate to injuries among children and 13 articles pertain to perception of safety. The results showed that high traffic volume and high vehicle speed are the main reasons children and parents feel unsafe when children use active travel, which matches the main findings on objective safety. Few articles on perception of safety related to the objective built environment were found. However, consistent findings exist. The presence of sidewalk was related to the safety of children. The presence of a crossing guard was positively related to perceived safety but was associated with higher rates of injuries among children. Intersection density was related to unsafe perceptions but was not statistically associated with objective traffic safety. Additionally, population density was found to be positively related to injuries among children, but not to perception of safety. The results help policy strategy to enhance the safety of children when using active transport modes.

School environments and social risk factors for child pedestrian-motor vehicle collisions: A case-control study

BACKGROUND

Child 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.

METHODS

Child 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).

RESULTS

The 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.

CONCLUSIONS

Several 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.

Use of geographic information systems to assess the error associated with the use of place of residence in injury research

Background

In any spatial research, the use of accurate location data is critical to the reliability of the results. Unfortunately, however, many of the administrative data sets used in injury research do not include the location at which the injury takes place. The aim of this paper is to examine the error associated with using place of residence as opposed to place of injury when identifying injury hotspots and hospital access.

Methods

Traumatic Brian Injury (TBI) data from the BC Trauma Registry (BCTR) was used to identify all TBI patients admitted to BC hospitals between January 2000 and March 2013. In order to estimate how locational error impacts the identification of injury hotspots, the data was aggregated to the level of dissemination area (DA) and census tract (CT) and a linear regression was performed using place of residence as a predictor for place of injury.

In order to assess the impact of locational error in studies examining hospital access, an analysis of the driving time between place of injury and place of residence and the difference in driving time between place of residence and the treatment hospital, and place of injury and the same hospital was conducted.

Results

The driving time analysis indicated that 73.3 % of the injuries occurred within 5 min of place of residence, 11.2 % between five and ten minutes and 15.5 % over 20 min. Misclassification error occurs at both the DA and CT level. The residual map of the DA clearly shows more detailed misclassification.

As expected, the driving time between place of residence and place of injury and the difference between these same two locations and the treatment hospital share a positive relationship. In fact, the larger the distance was between the two locations, the larger the error was when estimating access to hospital.

Conclusions

Our results highlight the need for more systematic recording of place of injury as this will allow researchers to more accurately pinpoint where injuries occur. It will also allow researchers to identify the causes of these injuries and to determine how these injuries might be prevented.

Do school crossing guards make crossing roads safer? A quasi-experimental study of pedestrian-motor vehicle collisions in Toronto, Canada

Background

The presence of school crossing guards has been associated with more walking and more pedestrian-motor vehicle collisions (PMVCs) in area-level cross-sectional analyses. The objectives of the study were to (1) Determine the effect on PMVC rates of newly implemented crossing guards in Toronto, Canada (2) Determine where collisions were located in relation to crossing guards throughout the city, and whether they occurred during school travel times.

Methods

School crossing guards with 50 m buffers were mapped along with police-reported child PMVCs from 2000–2011. (1) A quasi-experimental study identified all age collision counts near newly implemented guards before and after implementation, modeled using repeated measures Poisson regression adjusted for season and built environment variables. (2) A retrospective cohort study of all child PMVCS throughout the city to determine the proportions of child PMVCs which occurred during school travel times and at guard locations.

Results

There were 27,827 PMVCs, with 260 PMVCs at the locations of 58 newly implemented guards. Repeated measures adjusted Poisson regression found PMVCs rates remained unchanged at guard locations after implementation (IRR 1.02, 95 % CI 0.74, 1.39). There were 568 guards citywide with 1850 child PMVCs that occurred at guard locations. The majority of child PMVCs occurred outside school travel times (n = 1155, 62 %) and of those that occurred during school travel times, only 95 (13.7 %) were at a guard location.

Conclusions

School crossing guards are a simple roadway modification to increase walking to school without apparent detrimental safety effects. Other more permanent interventions are necessary to address the frequency of child PMVCs occurring away from the location of crossing guards, and outside of school travel times.

Altering school attendance times to prevent child pedestrian injuries

OBJECTIVES

The purpose of this research was to determine whether modifying school start time schedules can be used to reduce children's exposure to traffic on their morning walks to school.

METHODS

We use models of pedestrian and motor vehicle commuting to estimate the frequency of encounters between child pedestrians and motor vehicles at intersections throughout the City of Hamilton, Ontario, Canada. We use a simple heuristic to identify the school-specific start times that would most reduce the local frequency of encounters between motor vehicles and pedestrians.

RESULTS

Our analysis suggests that it may be possible to achieve an almost 15 percent reduction in the total number of encounters between child pedestrians and motor vehicles during the morning commute by staggering school start times such that the periods of high pedestrian activity are temporally staggered from periods of high motor vehicle activity. Our analysis suggests that small changes in school start times could be sufficient to see noteworthy reductions in pedestrian exposure to traffic.

CONCLUSIONS

Changing school times may be an effective, inexpensive, and practical tool for reducing child pedestrian injuries in urban environments. Enhanced transportation models and community-based interventions are natural next steps for exploring the use of school-specific scheduling to reduce the risk of child pedestrian injury. Further research is required to validate our models before this analysis should be used by policy makers.

Neighborhood social inequalities in road traffic injuries: the influence of traffic volume and road design

OBJECTIVES

We examined the extent to which differential traffic volume and road geometry can explain social inequalities in pedestrian, cyclist, and motor vehicle occupant injuries across wealthy and poor urban areas.

METHODS

We performed a multilevel observational study of all road users injured over 5 years (n=19,568) at intersections (n=17,498) in a large urban area (Island of Montreal, Canada). We considered intersection-level (traffic estimates, major roads, number of legs) and area-level (population density, commuting travel modes, household income) characteristics in multilevel Poisson regressions that nested intersections in 506 census tracts.

RESULTS

There were significantly more injured pedestrians, cyclists, and motor vehicle occupants at intersections in the poorest than in the richest areas. Controlling for traffic volume, intersection geometry, and pedestrian and cyclist volumes greatly attenuated the event rate ratios between intersections in the poorest and richest areas for injured pedestrians (-70%), cyclists (-44%), and motor vehicle occupants (-44%).

CONCLUSIONS

Roadway environment can explain a substantial portion of the excess rate of road traffic injuries in the poorest urban areas.