The identification of environmental factors in pediatric pedestrian motor vehicle crashes

Background: Pediatric pedestrian injuries are a major cause of childhood death, hospitalization, and disability. To target injury prevention efforts, it is imperative to identify those children at risk and the environmental factors that contribute to injury events. We hypothesized that injury event patterns reflect local traffic hazards for child pedestrians and attempted to identify local environmental factors that may be utilized in the planning of primary injury prevention programs. Methods: Utilizing E codes for pedestrian-motor vehicle crashes, children < 16 years of age were identified from the trauma registry, who received acute care and were hospitalized at the University of Chicago Hospital, a Level I pediatric trauma center, after being struck by a motor vehicle during the calendar years 2002, 2003, and 2004. By retrospective chart review, demographic and billing data were collected and details of the injury site were obtained from Emergency Medical Services (EMS) run sheets. Place of residence and injury site were mapped. Injury site visitation was performed to identify traffic hazards for selected clusters of injuries. The Center for Neighborhood Technology provided geographic information systems mapping of injury sites. Results: There were 1072 children admitted to the University of Chicago after sustaining trauma. In 2002, 2003, and 2004, 59, 90, and 123 children <16 years of age respectively, sustained pedestrian motor vehicle crashes. For each year, the number of patients with both place of residence and injury site identified were 40, 60, and 74, respectively. Males predominated, and the majority of patients were elementary school age as illustrated in Table 1. Cluster analysis of an injury site in the vicinity of an elementary school showed the majority of injury events occurred on school days, during school hours, within 1-2 blocks of the school, and that victims were the age of school attendees. Conclusions: In this preliminary study, data from the trauma registry were used to map out sites where pediatric pedestrian motor vehicle injury events have occurred during 3 consecutive years. Each year clusters of pedestrian-motor vehicle crashes involving children <16 years of age occurred at the same location. Performing detailed analyses over time in this fashion is useful in guiding injury prevention efforts in areas with similar demographics. Future targeted injury prevention efforts in areas will incorporate neighborhood schools, the city department of transportation, the park district, community members, and our hospital.