From targeted "black spots" to area-wide pedestrian safety.

OBJECTIVE To describe and illustrate the geographic distribution of pedestrian crash sites in an urban setting (Montreal, Canada) with an alternative data source. METHODS Data on pedestrian victims were extracted for a 5-year period (1999-2003) from ambulance services information systems. The locations of crash sites and pedestrian victim density were mapped using a geographic information system. Pedestrian "black spots" were defined as sites where there had been at least eight pedestrian victims. RESULTS The 22 identified black spots represent only 1% of all city intersections with at least one victim and 4% of all injured pedestrians, whereas 5082 victims were injured at >3500 different crash sites. The number and population rates of injured pedestrians are greater in central boroughs. Accordingly, the density of pedestrian victims is much higher in central boroughs. Over the 5-year period, in some central boroughs, pedestrian crashes occurred in up to 26% of intersections. CONCLUSIONS Ambulance information systems were relevant to map pedestrian crash sites. Most pedestrians were injured at locations that would have been missed by the black spot approach. This high-risk preventive strategy cannot substantially reduce the total number of injured or the insecurity that many pedestrians experience when walking. Considering the large number and widespread occurrence of pedestrian crashes in Montreal, prevention strategies should include comprehensive environmental measures such as global reduction of traffic volume and speed.