Developmental risk factors for childhood pedestrian injuries.

Pedestrian injuries remain a significant public health problem for children.' In 1992 in the United States, more than 600 children younger than 16 years of age died2 and an estimated 31 000 were non-fatally injured3 from pedestrian injuries. In that country, pedestrian injuries account for 6 30o of childhood fatalities from all causes between 1-14 years, and 9-30o of deaths from all causes in children between 5 and 9 years, the highest risk group in childhood.2 The childhood annual pedestrian death rate in other industrialized nations is similar: Australia 3 1,4 New Zealand 3 0,5 and the United Kingdom 2 46 deaths per 100 000 persons between 1 and 14 years old. Why are children, especially young children, at such high risk? Childhood pedestrian injuries result from a highly complex interaction of many possible factors.7 A full analysis would include risk factors related to the child, the driver, and the environment (table). In this review we consider only one aspect of the problem: the developmental attributes affecting the behavior of children that make them more likely to be struck by a vehicle. We address the