The incidence of injuries traveling to and from school by travel mode

Regional disparities in road traffic injury rates involving elementary and junior high school children while commuting among Japan's 47 prefectures between 2004 and 2013

OBJECTIVES

To investigate the extent and patterns of regional disparities of road traffic injury rates involving elementary and junior high school children while commuting among Japan's 47 prefectures.

METHODS

We conducted a cross-sectional ecological study using the national police data for 2004-2013 on the number of children who were killed or seriously injured (KSI) in traffic collisions stratified by prefecture, grade, mode of transport, and purpose of trip (commuting or non-commuting). We calculated stratified KSI rates by dividing the number of KSI cases by the corresponding number of children and presented these rates for the 47 prefectures. Also, for pedestrian elementary school children and cyclist junior high school children, we regressed the KSI rates while commuting by prefecture on the non-commuting KSI rates and the proportion of people who live in the urban, densely inhabited districts.

RESULTS

There were 6463 KSI cases while commuting. The ratios of the highest KSI rate to the lowest KSI rate among prefectures were 12, 30, and 58 for pedestrian elementary school children and pedestrian and cyclist junior high school children, respectively. The non-commuting KSI rates and the proportion of those living in densely inhabited districts were positively and inversely associated with the commuting KSI rates, respectively. The analysis of the residuals of the regression models did not identify prefectures with significantly higher or lower KSI rates while commuting than others.

CONCLUSIONS

There were large inter-prefecture disparities in the KSI rates while commuting, and the disparity was especially large among cyclist junior high school children.

Road traffic injuries to children during the school commute in Hyderabad, India: cross-sectional survey

BACKGROUND

India is motorising rapidly. With increasing motorisation, road traffic injuries are predicted to increase. A third of a billion children travel to school every day in India, but little is known about children's safety during the school commute. We investigated road traffic injury to children during school journeys.

METHODS

We conducted a cross-sectional survey in Hyderabad using a two-stage stratified cluster sampling design. We used school travel questionnaires to record any road injury in the past 12 months that resulted in at least 1 day of school missed or required treatment by a doctor or nurse. We estimated the prevalence of road injury by usual mode of travel and distance to school.

RESULTS

The total sample was 5842 children, of whom 5789 (99.1%) children answered the question on road injury. The overall prevalence of self-reported road injury in the last 12 months during school journeys was 17% (95% CI 12.9% to 21.7%). A higher proportion of boys (25%) reported a road injury than girls (11%). There was a strong association between road injury, travel mode and distance to school. Children who cycled to school were more likely to be injured compared with children who walked (OR 1.5; 95% CI 1.2 to 2.0). Travel by school bus was safer than walking (OR 0.5; 95% CI 0.3 to 0.9).

CONCLUSIONS

A sixth of the children reported a road traffic injury in the past 12 months during school journeys in Hyderabad. Injury prevention interventions should focus on making walking and cycling safer for children.

Breaking Out of Surveillance Silos: Integrative Geospatial Data Collection for Child Injury Risk and Active School Transport

The preponderance of active school transport (AST) and child injury research has occurred independently, yet they are inherently related. This is particularly true in urban areas where the environmental context of AST may pose risks to safety. However, it can be difficult to make these connections due to the often segregated nature in which these veins of research operate. Spatial video presents a geospatial approach for simultaneous data collection related to both issues. This article reports on a multi-sector pilot project among researchers, a children's hospital, and a police department, using spatial video to map child AST behaviors; a geographic information system (GIS) is used to analyze these data in the environmental context of child pedestrian injury and community violence.

Injury risk during different physical activity behaviours in children: a systematic review with bias assessment

INTRODUCTION

The current focus on a physically active lifestyle in children puts children at increased physical activity-related injury risk.

OBJECTIVE

To summarise, in a systematic review, the evidence for the injury risk of several physical activity behaviours in 6- to 12-year-old children.

METHODS

An electronic search was performed in three databases (Embase, PubMed and SPORTDiscus). Inclusion criteria were: age 6-12 years; report on injuries related to overall physical activity, active commuting, unorganised leisure time physical activity, physical education and/or organised sports; incidence rates expressed as injuries per hours of physical activity; and published after January 1st 2000. Risk of bias was assessed for all studies included.

RESULTS

Eight studies were included. The risk of bias assessment resulted in two studies with a score that was higher than 75 %; risk bias of those two studies was considered low. The medically treated, injury incidence rate was reported to be between 0.15 and 0.27 injuries per 1,000 h of physical activity. The absolute number of injuries related to unorganised leisure time physical activity was higher than the absolute number of injuries reported in organised sports. The respective injury incidence rate expressed per 1,000 h exposure was, however, generally lower during unorganised leisure time than during organised sports. Reported injury incidence rates related to active commuting were comparable to those for unorganised leisure time physical activity. Conflicting injury incidence rates were reported for physical education. Subgroup analysis suggested that girls and children with low habitual levels of physical activity are at increased injury risk. A limitation of the review is that no standard bias assessment was available for this specific context.

CONCLUSIONS

Children are at an inherent injury risk while participating in physical activities. Most injury prevention efforts have focussed on the sports setting, but our results suggest that many children sustain an injury during unorganised leisure time physical activities.

Assessing multimodal school travel safety in North Carolina

School transportation has been the subject of numerous federal and state policies since the early twentieth century-the Safe Routes to School program is the most recent example. However, few recent studies have thoroughly analyzed the risks and costs associated with different modes of transportation to school. Our descriptive study assessed the injury and fatality rates and related safety costs of different modes of school transportation using crash and exposure data from North Carolina, USA from 2005 to 2012. We found that riding with a teen driver is the most dangerous mode on a per trip basis with injury rates 20 times higher and fatality rates 90 times higher than school buses, which had the lowest injury rates. Non-motorized modes had per trip injury rates equivalent to school buses but per trip fatality rates were 15 times higher than for school buses. The economic costs of school travel-related injuries and fatalities for walking, biking, and teen drivers were substantially higher than other modes. This research has important policy implications because it quantified the risks of different school travel modes which allows policymakers to consider how safety investments can reduce risks. Decades of effort by schools, communities, and the government have made school buses a very safe mode and endeavored to reduce risks to teen drivers. This study highlighted the need for these same actors to reduce the risks of injury for walking and bicycling. As more improvements are made to infrastructure around schools, repeated studies of this type will allow practitioners to examine whether the improvements help mitigate the risks.

Analysing the development of road safety using demographic data

The purpose of this paper is to show that time series analyses of road safety and risk can be improved by using demographic data. We demonstrate that the distance travelled by drivers or riders of a certain age reflects the fluctuations over the years of the number of people of that age within the population. We further demonstrate that the change over time of per capita distance travelled, i.e. distance travelled per person, is often less subject to stochastic fluctuations, and therefore more smooth than the total distance travelled for drivers of that age. This smoothness is used to obtain forecasts of distance travelled, or to average out year-to-year fluctuations of data of distance travelled. Analysis of such data stratified by age group, gender or both reveals that, for most travel modes, per capita distance travelled is to a large extent constant or slowly changing over time. The consequences for the evaluation of risk, i.e. casualties per distance travelled, with and without the use of population data, are explored. Dutch data are used to illustrate the model concept. It is shown that the analyses and forecasts of distance travelled could gain substantially by incorporating demographic data, as compared to an analysis with data of distance travelled alone. The paper further shows that, for an analysis of risk and therefore for traffic safety forecasts in the absence of any data of distance travelled, stratified analysis of mortality, i.e. casualties per inhabitant, may be a reasonable alternative.

Exploring differential trends in severe and fatal child pedestrian injury in New South Wales, Australia (1997-2006)

The study explores trends in severe and fatal child pedestrian injuries in New South Wales (NSW), over the 10-year period 1997-2006, in comparison to adults and for various subgroups. Data on pedestrian injury (reported as fatalities or hospitalisations) were obtained from the Traffic Accident Database System (TADS; Roads and Traffic Authority of New South Wales) which captures road traffic events reported to police, and from the NSW Admitted Patients Data Collection (APDC) which captures all hospital inpatient separations. Annual percentage changes in injury counts and rates were compared using Poisson regression. A substantial drop in the pedestrian injury rate was observed; however, the rate of decline was steeper for children (aged less than 15 years) than for adults. The drop in child pedestrian injury was manifest in both the police report data and the hospital admission data. The annual percentage decrease was significantly greater for boys than for girls, and the three major urban centres compared with elsewhere in the state. No differences were detected in the annual rate decrease between school days and non-school days (a proxy for safe school zones), or between different road types (a proxy for restricted speed limits). Past research suggests that injury rate reductions are not solely due to decreased exposure. There remains, however, limited data on the extent of pedestrian mobility. Differences in relative reduction in pedestrian injury rates suggest a differential benefit arising from road safety initiatives.