Children at risk in traffic: improvement potentials in the Swedish context.
OBJECTIVE
To investigate the social risk distribution and improvement potentials for road traffic injuries among Swedish children by considering three categories of road users.


METHODS
A population-based cohort study of children aged 1-14 y was carried out. Subjects were taken from the Swedish Population and Housing Census of 1990 (n = 1406405), and followed-up in the National Hospital Discharge Register for the years 1991-1999 focusing on injuries incurred as pedestrians, bicyclists or car passengers (n = 16084). Household socio-economic position was measured using social class, education and disposable income. Relative risks were calculated using Poisson regression for each measure of socio-economic position and by combining them, adjusting for sex, age of child and age of mother at delivery. Population-attributable risks were compiled for each category of road user and each measure of socio-economic position.


RESULTS
Children of farmers and the self-employed are at greater risk for injuries as car passengers (RR 2.40, CI 1.79-3.20 and RR 1.44, CI 1.16-1.79, respectively), but not for pedestrian- and bicycle-related injuries. Children of unskilled workers are at greater risk for pedestrian injuries (RR 1.39, CI 1.15-1.67). Controlling for education and disposable income did not affect the relative risks to the same extent according to the social class and category of road user. The highest population-attributable risks were related to family disposable income and were indicated for pedestrians and car passengers (19-20%).


CONCLUSIONS
By taking children's limited ability to deal with different types of traffic situations into consideration, considerable improvements in children's risk levels have been observed. Now there is a need to add equity in the road traffic safety equation.
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden. marie.hasselberg@smd.sll.se
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D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D001642:Bicycling / Q000293:injuries* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004522:Educational Status; D006801:Humans; D015994:Incidence; D007182:Income; D007223:Infant; D012042:Registries; D012306:Risk; D012923:Social Class; D013548:Sweden / Q000453:epidemiology