Patterns of injury to young pedestrians: a case study

In 35 of the selected cases (42%), the child was struck by a vehicle. The proportion of cases in which young pedestrians were actually struck by a vehicle rose steeply with age: 75 per cent of two-year-olds; 88 per cent of three-year-olds; and 91 per cent of four-year-olds. Typically, the collision occurred when a child was struck by a reversing vehicle (n=11); ran across the road and/or into the path of an oncoming vehicle (n=10); or was in the process of crossing the road--in some cases accompanied by an adult (n=9). The resultant injuries were often severe, 60 per cent requiring admission to hospital. The incidents involving reversing vehicles most often occurred in driveways, and occasionally in car parks. By the age of two years, the proportion of cases involving reversing vehicles had declined to 4 per cent and, by four years of age, no such cases were recorded.

The remaining 49 cases (58%), represent incidents in which the child had the potential to be struck by a vehicle, but where this outcome was avoided. As expected, the injury consequences of these cases were generally less severe, none resulting in admission to hospital. The circumstances surrounding the cases were two-fold: the child being injured when falling onto the road surface (sometimes from the kerb) (n=19) or when being pulled by the hand or arm in an attempt to remove it from danger (n=30). Cases of injury resulting from arm pulling most often resulted in a dislocated or sprained elbow and were confined to a very narrow age range (from 12 months to 38 months). The pattern of risk changes as children grow. As children become mobile, they are able to move around vehicles at increasing speed. Parents are often unaware of their rapidly increasingly capabilities. As children grow older they show signs of recognising hazards and are given a little more freedom. Their judgement, however, is inconsistent and parents often need to intervene to prevent a disaster.

Prevention strategies are not simple because close supervision at all times is impossible. Environmental control strategies that separate the child from the traffic flow on both road and driveway or provide a means of actively controlling unexpected movements by the child when in high risk areas are more likely to be reliable than behavioural control strategies.