title: Turning at intersections and pedestrian injuries.
abstract: OBJECTIVE
  To evaluate if precrash vehicle movement is associated with the severity of pedestrian injury.
  
  
  METHODS
  We used comprehensive information on pedestrian, vehicle, and injury-related characteristics gathered in the Pedestrian Crash Data Study (PCDS), conducted by the National Highway Traffic Safety Administration (NHTSA) (1994-1998). The odds ratio of severe injuries (injury severity score >/= 15) and crash fatality rate for right- and left-turn collisions at intersection compared with straight vehicle movement were compared using a logistic regression model and taking into consideration the type of vehicle and age of the pedestrians as potential effect modifiers. Later we evaluated the intermediate effect of impact speed on the association by adding it to the logistic regression model.
  
  
  RESULTS
  Of 255 collisions eligible for this analysis, the proportion of pedestrian hit during straight movement, right turns, and left turns were 48%, 32%, and 10%, respectively. Sixty percent of the pedestrians in left-turn crashes and 67% of them in right-turn collisions were hit from their left side. For straight movements the pedestrians were equally likely to be struck beginning from the left or right side of the street. After adjustment for pedestrian's age, vehicle movement was a significant predictor of severe injuries (p < 0.0001) and case fatality (p = 0.003). The association between vehicle precrash movement and severe injuries (p = 0.551) and case fatality (p = 0.912) vanished after adjusting for impact speed. This indicated that the observed association was probably the result of the difference in impact speed and not the precrash movement of the vehicle.
  
  
  CONCLUSIONS
  Pedestrian safety interventions that aim at environmental modifications, such as crosswalk repositioning, might be the most efficient means in reducing right- or left-turn collisions at intersection, while pedestrians' behavioral modifications should be the priority for alleviating the magnitude of the collisions that happen in vehicles' straight movements.
authors.affiliation: Department of Epidemiology and Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington, USA. roudsari@u.washington.edu
authors.forename: Bahman
authors.initials: B
authors.lastname: Roudsari
authors.forename: Robert
authors.initials: R
authors.lastname: Kaufman
authors.forename: Thomas
authors.initials: T
authors.lastname: Koepsell
mesh_terms: D015998:Abbreviated Injury Scale; D000054:Acceleration; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012420:Running; D014481:United States / Q000453:epidemiology; D016138:Walking; D014947:Wounds and Injuries / Q000453:epidemiology*