Differences in child pedestrian injury events by location.

OBJECTIVE To compare child pedestrian injury events occurring in driveways and parking lots and at midblock and intersections with respect to characteristics and activity of the child, injury outcome measures, and characteristics of the vehicle and roadway. DESIGN Descriptive case series. SETTING Data were obtained from a multihospital/coroner monitoring system, during 2 years in an urban county, by record review and interviews. PATIENTS The sample consisted of 345 pedestrians 0 through 14 years of age treated for injuries at one of the participating facilities. RESULTS Eleven percent were injured in driveways, 8% in parking lots, 53% at midblock, and 28% at intersections. Median age was 2 years for driveways, 4 years for parking lots, 6 years for midblock, and 10 years for intersection. Events in driveways and parking lots had significantly more vehicles backing up, fewer automobiles, and more pedestrians with adults. Events at intersections occurred more often on streets with more than two lanes, with speed limits > 25 mph, and with moderate or heavy traffic than events at midblock. Sixteen percent of those injured in driveways and parking lots sustained head injury of moderate or greater severity versus 35% injured in the street. CONCLUSIONS Interventions to prevent child pedestrian injuries must consider normal child behavior and driver awareness as it relates to location of the events. Driveway events involve small children, larger vehicles, and backing up. Midblock events involve children too young to cross even quiet residential streets safely. Traffic controls and safe street crossing skills are measures to consider for intersection events involving older children.