Blaming children for child pedestrian injuries

Blame attribution analysis of police motor vehicle collision reports involving child bicyclists

BACKGROUND

Injuries resulting from collisions between a bicyclist and driver are preventable and have high economic, personal and societal costs. Studying the language choices used by police officers to describe factors responsible for child bicyclist-motor vehicle collisions may help shift prevention efforts away from vulnerable road users to motorists and the environment. The overall aim was to investigate how police officers attribute blame in child (≤18 years) bicycle-motor vehicle collision scenarios.

METHODS

A document analysis approach was used to analyse Alberta Transportation police collision reports from Calgary and Edmonton (2016-2017). Collision reports were categorised by the research team according to perceived blame (child, driver, both, neither, unsure). Content analysis was then used to examine police officer language choices. A narrative thematic analysis of the individual, behavioural, structural and environmental factors leading to collision blame was then conducted.

RESULTS

Of 171 police collision reports included, child bicyclists were perceived to be at fault in 78 reports (45.6%) and adult drivers were perceived at fault in 85 reports (49.7%). Child bicyclists were portrayed through language choices as being irresponsible and irrational, leading to interactions with drivers and collisions. Risk perception issues were also mentioned frequently in relation to poor decisions made by child bicyclists. Most police officer reports discussed road user behaviours, and children were frequently blamed for collisions.

CONCLUSIONS

This work provides an opportunity to re-examine perceptions of factors related to motor vehicle and child bicyclist collisions with a view to prevention.

Child Pedestrian Safety: Study of Street-Crossing Behaviour of Primary School Children with Adult Supervision

Road traffic accidents are the primary cause of injuries and fatalities among children. The current study focuses on children’s (un)safe crossing behaviour in a real traffic situation accompanied by an adult at a crosswalk in front of their school. The study aims to investigate if there are differences in crossing behaviour related to road infrastructure (i.e., one-way and two-way street, elevated and non-elevated street crossing), the gender of the child, and the effect of the accompanying adult’s behaviour on the child’s crossing behaviour. Primary school children from two urban schools in Flanders (Belgium) were observed for three days while crossing the street in front of their school in the morning and afternoon. A total of 241 child–adult pairs were observed. Descriptive analysis, Pearson chi-square tests, and binary logistic regression models were used to find differences between groups. More than half of the crossings exhibited two or more unsafe behaviours. Not stopping at the curb before crossing was the most unsafe behaviour, exhibited by 47.7% of children; not looking for oncoming traffic before and during the crossing was the second most unsafe behaviour, exhibited by 39.4% of the children. The only difference between boys’ and girls’ crossing behaviour was in stopping at the curb with girls 1.901 times more likely to stop before crossing as compared to boys. Adults holding hands of the child resulted in safer behaviours by children. The children not holding hands displayed significantly riskier behaviour in running or hopping while crossing the street and being distracted. The study reinforces the need to improve the transportation system through infrastructural interventions (elevated crosswalks), as well as educating and training children and the parents on safe crossing behaviour in traffic.

Children and Infants in Aviation Accidents

BACKGROUND: This study examines the relationship between seat restraints and injuries of children and infants who were passengers on an aircraft and gives a detailed analysis of children whose behavior contributed to an accident.METHODS: A total of 58 accident reports from 1980 until 2015 were extracted from the NTSB online database in which children were mentioned. In at least 10 cases the childs behavior contributed to the accident.RESULTS: Violations of regulations by the Federal Aviation Authority (FAA) as well as the age and number of children and infants on board were each reported inconsistently. Violations of regulations were significantly more common when accidents occurred during the takeoff phase. Child behaviors that caused accidents included distraction of crew, not wearing a seatbelt, and running into dangerous areas.CONCLUSIONS: Pilots and crew, especially in General Aviation, need to be made aware of the need to enforce FAA regulations concerning child restraint systems. It is recommended that children both on the ground and inside an aircraft have adult supervision in addition to supervising aircraft crew to prevent distractions that harm the safe operation of an aircraft.Kalagher H, de Voogt A. Children and infants in aviation accidents. Aerosp Med Hum Perform. 2021; 92(5):353357.

Neighbourhood characteristics associated with child pedestrian fatalities in Johannesburg, South Africa

The present study investigated the relationship between neighbourhood characteristics and childhood pedestrian fatalities (2001-2010) in Johannesburg, South Africa. This cross-sectional study used negative binomial regression models. Results indicate that: areas with high concentrated disadvantage have elevated childhood pedestrian deaths, especially for those aged 5 to 9 years. Areas marked by residential mobility are associated with high pedestrian deaths among children 0 to 4 years. Black childhood pedestrian deaths are higher in areas marked by a high concentration of female-headed households. The analyses highlight the value of further exploring the effects of neighbourhood characteristics and suggest points of entry for interventions to reduce or prevent childhood pedestrian traffic mortality.

Identifying motorist characteristics associated with youth bicycle-motor vehicle collisions

Objective: The objective of this study was to identify driver characteristics associated with youth bicycle-motor vehicle collisions in Alberta, Canada. Methods: Edmonton and Calgary police collision report data from the years 2010-2014 were used. From these data, motor vehicle collisions involving youth (<18 years old) were identified (cases). The controls were drivers who, over the same period, were involved in separate motor vehicle-only collisions but deemed not at fault using an automated culpability analysis. Control selection used the quasi-induced exposure method, assuming that not-at-fault drivers in collisions are representative of the typical driver (source population). Descriptive statistics, including proportions, medians, and interquartile ranges (as appropriate) were used to describe the characteristics of the case and control drivers. Purposeful variable selection techniques were used to inform multivariable logistic regression models and results are presented as adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: Four hundred twenty-three drivers involved in youth bicycle-motor vehicle collisions were identified, as were 243,927 not-at-fault control drivers. Drivers >54 years old had higher odds of involvement in youth bicycle-motor vehicle collisions than drivers between 25 and 39 years old (aOR = 1.37; 95% CI, 1.03, 1.82). Compared to driving between 3:01 p.m. and 6:00 p.m., driving between 12:01 a.m. and 6:00 a.m. (aOR = 0.27; 95% CI, 0.11, 0.66), between 6:01 a.m. and 9:00 a.m. (aOR = 0.61; 95% CI, 0.44, 0.85), or between 9:01 a.m. and 12:00 p.m. (aOR = 0.26; 95% CI, 0.16, 0.41) had lower odds of bicyclist collision, whereas driving between 6:01 p.m. and 12:00 a.m. had higher odds (aOR = 1.34; 95% CI, 1.01, 1.79). Driving a truck/van had lower odds of bicyclist collision compared to driving a passenger car (aOR = 0.67; 95% CI, 0.48, 0.94). Conclusions: Culpability analysis is typically applied to motorists to identify transient exposures; however, this study used culpability analysis to select control drivers who could be compared with drivers involved in youth bicycle-motor vehicle collisions. This study highlights motorist characteristics in youth bicycle-motor vehicle collisions. In doing so, we hope to inform primary prevention strategies for motorists and the environment that will reduce collisions.

Speaking about accidents: the ideology of auto safety

Discourses about traffic accidents are limited by an ideology of automobility that has accompanied increased auto dependence and the hegemony of the automobile over social space. Risk analyses swing back and forth from targeting either human error or technical improvement. While both are important, the attribution of accident causation to systemic factors remains largely ignored. Even in targeting human error, focus is often restricted to causes that are manageable within the existing system, e.g. drunken driving. In reality, there are many human errors and impairments that are implicated in road accidents. Thus, what is significant is that because auto-centered transport depends upon the constant ‘sobriety’ of all traffic participants, impaired driving, walking and cycling are inevitable. Another salient feature of auto-centered transport systems neglected by safety experts is the dominance of ‘hard’ means of mobility. Many argue that larger and heavier vehicles are safer, but the question is for whom and in what traffic and social contexts. In auto-centered transport, some participants, e.g. children and cyclists, who use ‘soft’ means of mobility are particularly disadvantaged. Safety is also differentiated by status (e.g. social class) factors; for example, poorer persons drive poorer vehicles. The lack of attention to systemic factors in safety discourses is congruent with the general culture of individual automobility, which assumes the superiority of auto-centered transport over other, more diversified, structures of movement.

A study of a decade of road traffic accidents in Benghazi-Libya: 2001 to 2010

This paper aims to observe and to study the trends of road traffic accidents (RTA’s) for the past ten years in Benghazi – Libya. A retrospective analysis was done using the patient records of Al-Jalaa hospital (the main trauma center in Benghazi) from over 21,753 RTA cases. The annual data were compared to each other and changes of trends were observed. RTA’s represented an increasing percentage of Al-Jalaa’s case load across the years. Around 41% of these cases needed to undergo surgery. The younger age group (20–29 years of age) formed the majority of cases while there was a trend towards an increasing average age of patients involved in an accident. Male patients were found to be younger than their female counterparts. Males comprised 81.5% while females formed 18.5% of RTA patients. In terms of inpatient duration, most patients stayed in the hospital for less than 1 week. Vehicle occupants (drivers and passengers) were admitted more often than pedestrians. There was a trend across the years towards an increased involvement of vehicle occupants and decrease in the proportion of pedestrians that had to be hospitalized. Additionally, there was a decrease in the fatalities of pedestrians. Overall, most RTA patients were discharged and made to follow-up in outpatient clinics however there was a startling trend towards increased LAMA and absconded patients. There were both encouraging findings as well as points that needed further emphasis and action. Public education, life support training and diversification of transport (apart from the use of the roads) should be looked into, as possible means of improving the current situation.

Pedestrian-vehicle crashes and analytical techniques for stratified contingency tables

In 1999 there were 450 fatalities due to road crashes in Riyadh, the capital of Saudi Arabia, of which 130 were pedestrians. Hence, every fourth person killed on the roads is a pedestrian. The aim of this study is to investigate pedestrian-vehicle crashes in this fast-growing city with two objectives in mind: to analyze pedestrian collisions with regard to their causes, characteristics, location of injury on the victim's body, and most common patterns and to determine the potential for use of the odds ratio technique in the analysis of stratified contingency tables. Data from 638 pedestrian-vehicle crashes reported by police, during the period 1997-1999, were used. A systematic sampling technique was followed in which every third record was used. The analysis showed that the pedestrian fatality rate per 10(5) population is 2.8. The rates were relatively high within the childhood (1-9 years) and young adult (10-19 years) groups, and the old-age groups (60 - > 80 years), which indicate that young as well as the elderly people in this city are more likely to be involved in fatal accidents of this type than are those in other age groups. The analysis revealed that 77.1% of pedestrians were probably struck while crossing a roadway either not in a crosswalk or where no crosswalk existed. In addition, the distribution of injuries on the victims' bodies was determined from hospital records. More than one-third of the fatal injuries were located on the head and chest. An attempt was made to conduct an association analysis between crash severity (i.e. injury or fatal) and some of the study variables using chi-square and odds ratio techniques. The categorical nature of the data helped in using these analytical techniques.

The safe journeys of an enterprising school: negotiating landscapes of opportunity and risk

In this paper, we discuss recent efforts to improve the safety of children travelling to and from New Zealand's largest primary school. The results of a travel survey completed by parents and pupils are reported, together with our recommendations for reducing congestion at the school gate and promoting healthy alternatives to car travel. Reflecting on this research, we find that market-oriented education reforms have provided schools with strong incentives for increasing their rolls--a course of action which may endanger pupils' well-being. At the same time, they have provided some schools with opportunities for resisting the present urban (dis)order and promoting community health.

Analysis of circumstances and injuries in 217 pedestrian traffic fatalities

We performed a retrospective analysis of 217 pedestrian traffic fatalities in Seattle, WA, U.S.A. that occurred over a six-year period using medical examiner records with essentially all of the deaths examined by autopsy. The annual pedestrian fatality rate for the county averaged 2.0/100,000 for all ages and both sexes, and the age-specific rate varied from 1.0/100,000 for the 22-34 year age group to 1.5/100,000 for children under seven years and 7.0/100,000 for ages 70 years and older. Males had a 50% higher rate than females. Fatal accidents were most common during December and January and during the evening hours. Wednesday had the greatest number of accidents leading to death, 79% higher than the Saturday weekend rate. Of those tested, 24% had ethanol in their blood. 66% of the fatal injuries occurred on city or residential streets, and 29% occurred on major thoroughfares. A single urban highway accounted for 12% of pedestrian fatalities and represented a particularly hazardous traffic environment. Fatal head injuries and severe chest injuries were present in 73% of cases; injuries involving multiple sites were present in 60%. There were few significant differences in the extent of injuries with respect to vehicle speed or type of vehicle. Head injuries were much less common in the oldest age group, probably because elderly pedestrians were more vulnerable to death from less severe trunk and extremity injuries. Severe chest injury was the most important predictor of death occurring at the scene.

Disease ecology and a reformist alternative: the case of infant mortality

This paper attempts to shed some light on the recent debate between those who advocate a reformed medical geography and those who respond that reform is not necessary. We show that disease ecology and a reformist alternative display certain tendencies in the ways in which they address issues of health and disease. We use the example of geographic variations in infant mortality rates to show how two non-positivist perspectives from social theory, political economy and humanism, support a reformist viewpoint, while also acknowledging the value of a complementary disease ecology approach. Two concepts, the social construction of health and illness and social relevance, are used to portray the political economy approach; humanism is described in terms of the meaning of individual experience and the importance of place. The paper concludes with a discussion of the respective roles of disease ecology and a reformist approach in models of infant mortality and a summary of the main differences between the two perspectives.

Effect of environmental factors on risk of injury of child pedestrians by motor vehicles: a case-control study

OBJECTIVE

To identify and assess contribution of environmental risk factors for injury of child pedestrians by motor vehicles.

DESIGN

Community based case-control study. Environmental characteristics of sites of child pedestrian injury were compared with the environmental characteristics of selected comparison sites. Each comparison site was the same distance and direction from home of control child as was the injury site from home or relevant case child. Two control sites were selected for each injury site.

SETTING

Auckland region of New Zealand.

SUBJECTS

Cases were 190 child pedestrians aged < 15 who were killed or hospitalised after collision with a motor vehicle on a public road during two years and two months. Controls were 380 children randomly sampled from population and frequency matched for age and sex.

MAIN OUTCOME MEASURE

Traffic volume and speed and level of parking on curbs at injury sites and comparison sites.

RESULTS

Risk of injury of child pedestrians was strongly associated with traffic volume: risk of injury at sites with highest traffic volumes was 14 times greater than that at least busy sites (odds ratio 14.30; 95% confidence interval 6.98 to 29.20), and risk increased with increasing traffic volume. High density of curb parking was also associated with increased risk (odds ratio 8.12; 3.32 to 19.90). Risk was increased at sites with mean speeds over 40 km/h (odds ratio 2.68; 1.26 to 5.69), although risk did not increase further with increasing speed.

CONCLUSION

Reducing traffic volume in urban areas could significantly reduce rates of child pedestrian injury. Restricting curb parking may also be effective.