title: Urban crash-related child pedestrian injury incidence and characteristics associated with injury severity.
abstract: OBJECTIVE
  Describe age-based urban pedestrian versus auto crash characteristics and identify crash characteristics associated with injury severity.
  
  
  METHODS
  Secondary analysis of the 2004-2010 National Highway and Traffic Safety Administration database for Illinois. All persons in Chicago crashes with age data who were listed as pedestrians (n=7175 child age ≤19 yo, n=16,398 adult age ≥20 yo) were included. Incidence and crash characteristics were analyzed by age groups and year. Main outcome measures were incidence, crash setting, and injury severity. Multivariate logistic regression analysis was performed to estimate injury severity by crash characteristics.
  
  
  RESULTS
  Overall incidence was higher for child (146.6 per 100,000) versus adult (117.3 per 100,000) pedestrians but case fatality rate was lower (0.7% for children, 1.7% for adults). Child but not adult pedestrian injury incidence declined over time (trend test p<0.0001 for <5 yo, 5-9 yo, and 10-14 yo; p<0.05 for 15-19 yo, p=0.96 for ≥20 yo). Most crashes for both children and adults took place during optimal driving conditions. Injuries were more frequent during warmer months for younger age groups compared to older (χ(2)p<0.001). Midblock crashes increased as age decreased (p<0.0001 for trend). Most crashes occurred at sites with sub-optimal traffic controls but varied by age (p<0.0001 for trend). Crashes were more likely to be during daylight on dry roads in clear weather conditions for younger age groups compared to older (χ(2)p<0.001). Daylight was associated with less severe injury (child OR 0.93, 95% CI 0.87-0.98; adult OR 0.90, 95% CI 0.87-0.93).
  
  
  CONCLUSIONS
  The incidence of urban pedestrian crashes declined over time for child subgroups but not for adults. The setting of pedestrian crashes in Chicago today varies by age but is similar to that seen in other urban locales previously. Injuries for all age groups tend to be less severe during daylight conditions. Age-based prevention efforts may prove beneficial.
authors.affiliation: Ann and Robert H. Lurie Children's Hospital of Chicago, Pediatric Emergency Medicine, 225 East Chicago Avenue, Box 62, Chicago, IL 60611-2605, USA; Northwestern University, McGaw Medical Center, Chicago, IL, USA. Electronic address: jkoopmans@luriechildrens.org.
authors.forename: Joy M
authors.initials: JM
authors.lastname: Koopmans
authors.affiliation: School of Public Health, University of Illinois at Chicago, 504 SPH-W, M/C 922, 1603 W. Taylor St, Chicago, IL 60612, USA. Electronic address: lfried1@uic.edu.
authors.forename: Lee
authors.initials: L
authors.lastname: Friedman
authors.affiliation: Ann and Robert H. Lurie Children's Hospital of Chicago, Smith Child Research Program, 680 N Lake Shore Drive, Suite 15163, Chicago, IL 60611, USA; Northwestern University, Feinberg School of Medicine, Pediatrics, Chicago, IL, USA. Electronic address: skwon@luriechildrens.org.
authors.forename: Soyang
authors.initials: S
authors.lastname: Kwon
authors.affiliation: Ann and Robert H. Lurie Children's Hospital of Chicago, Pediatric Emergency Medicine, 225 East Chicago Avenue, Box 62, Chicago, IL 60611-2605, USA; Northwestern University, Feinberg School of Medicine, Pediatrics and Preventive Medicine, Chicago, IL, USA. Electronic address: ksheehan@luriechildrens.org.
authors.forename: Karen
authors.initials: K
authors.lastname: Sheehan
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007087:Illinois; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D014505:Urban Population; D016138:Walking; D055815:Young Adult
keywords: Adolescent; Child; Epidemiology; Pedestrian injury; Urban