Childhood pedestrian injuries: preventable tragedies

provided by American Academy of Orthopaedic Surgeons

edestrian injury is second only to cancer as the leading cause of death of children between the ages of five and nine years. According to a recently completed study published in the Journal of Bone and Joint Surgery (May 2002), childhood pedestrian trauma can be greatly reduced with the help of environment and community interventions.

    Speaking at the American Academy of Orthopaedic Surgeons' Orthopaedics Update 2002 web conference, Thomas S. Renshaw, MD, coauthor of the study and Chief of Pediatric Orthopaedics at Yale University School of Medicine, New Haven CT., explained that the problem of childhood pedestrian injuries can be attributed to sociological and demographic factors. “Low-income areas with high populations experience more childhood pedestrian trauma. Although those factors may be out of our control, it is still possible to reduce the number of accidents by initiating some simple interventions.”

    Dr. Renshaw, along with colleagues Gregory A. Merrell, MD, Jon C. Driscoll, MD and Linda C. Degutis, PhD, all from Yale University School of Medicine, examined the frequency and location of childhood pedestrian injuries in New Haven over two 18-month periods.

    The factors affecting the frequency of such injuries, including population, vehicle regulations and laws, and traffic patterns, did not change significantly between the first study period, June 1992 to December 1993, and the second study phase, June 1998 to December 1999. Yet childhood pedestrian-motor vehicle collisions decreased from 223 in 1993 to 87 in 1999.

    During the six-year span between the two fact-finding periods, New Haven officials implemented five initiatives that may account for the decrease in injuries:

  • Improved safety education for children as a formal part of the school curriculum
  • Expanded school busing to reduce the number of children walking to school
  • A safe driving campaign promoting careful driving for all city residents
  • Decentralized public housing to reduce the childhood population density in poor and crowded neighborhoods
  • Increased traffic tickets and warnings issued by police in high-risk and high-population areas

    The result of these initiatives was a 61 percent decline in pedestrian-motor vehicle collisions involving children.

    Although additional studies over longer periods of time may be necessary to determine whether the improvements will be permanent, similar results have been reported in other locations. Researchers found a substantial decrease in pedestrian injuries as a result of pedestrian safety programs in four Alabama schools, as well as in Milwaukee, Los Angeles and Columbus, Ohio.

    According to Dr. Renshaw, most pedestrian-motor vehicle accidents happen because of driver distraction. “Cell phones are a huge factor – there's no way a driver can devote his full attention to the road when he's on the phone.”

    In addition to cellular phone bans, initiatives communities could consider to reduce child pedestrian injuries include:

  • Crossing guards at high-risk corners
  • Well-lit crosswalks with reflectors embedded in the pavement
  • Pedestrian overpasses
  • Highly visible warning signs for motorists in high-risk areas
  • One-way streets
  • Parking bans
  • Speed bumps
  • Longer traffic lights to give children more time to cross and to slow motorists between signals

    An orthopaedic surgeon is a physician with extensive training in the diagnosis and nonsurgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.
  The 25,500 member American Academy of Orthopaedic Surgeons or, is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade, the global initiative in the years 2002-2011 to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade in support of these objectives.