WalkSafe: a school-based pedestrian safety intervention program

OBJECTIVE: To evaluate the effectiveness of the WalkSafe program, an elementary school-based pedestrian safety program in a single high-risk district in Miami-Dade County. METHODS: Sixteen elementary schools were identified in a single high-risk district and enrolled in a one-year study. All schools implemented the WalkSafe program on the last week of January 2003. A pre, post, and three-month post testing of pedestrian safety knowledge was conducted. An observational component was also implemented at four schools that were randomly chosen. Engineering recommendations and law enforcement initiatives were also performed. RESULTS: A total of 6467 children from K-5th grade from 16 elementary schools participated in the program. Of these 5762 tests were collected over three different testing times. A significant difference (p-value < 0.001) was found between the pre and post testing conditions across all grade levels. There was no significant difference found between the post and three-month post testing conditions across all grade levels (p-value > 0.05). The observational data collected at four schools across the different testing times demonstrated a significant difference found between pre and post testing conditions for Group A (stop at the curb and look left, right, left) and also for Group B (midstreet crossing and darting out) (p-value < 0.05). There was no difference found between comparing the pre-test or post-test condition with the three-month post-test time. There were many environmental modifications that were recommended and actually performed. CONCLUSION: The WalkSafe program implemented in a single high-risk district was shown to improve the pedestrian safety knowledge of elementary school children. The observational data demonstrated improved crossing behaviors from pre-test to post-testing conditions. Future research will focus on sustaining the program in this district and expanding the program throughout our county.     

Parental supervision and discomfort with children walking to school in low-income communities in Cape Town,South Africa

Objective: The risk of pedestrian injury is compounded for children living in low-income communities due to factors such as poor road and pedestrian infrastructure, reliance on walking as a means of transport, and compromised supervision. Parents play an important role in child pedestrian safety. The primary objective of this study was to examine the effects of child pedestrian variables on parental discomfort with regard to letting their child walk to and from school and on the frequency of adult supervision.

Methods: A cross-sectional study was conducted using a convenience sample from 3 schools participating in a pedestrian safety school initiative. The schools are situated in low-income, high-risk communities in the City of Cape Town. A parent survey form was translated into isiXhosa and sent home with learners to those parents who had consented to participate. The response rate was 70.4%, and only parents of children who walk to and from school were included in the final sample (n = 359). Child pedestrian variables include the time taken to walk to school, parental rating of the child's ability to safely cross the road, and the frequency of adult supervision.

Results: More than half of parents reported that their child walked to and from school without adult supervision. About 56% of children took less than 20 min to walk to school. Most parents (61%) were uncomfortable with their child walking to school, although the majority of parents (55.7%) rated their child's ability to cross the road safely as better or significantly better than average (compared to peers). The parents did not perceive any differences in pedestrian risk factors between boys and girls or between younger (6–9 years) and older (10–15 years) children. The time spent by a child walking to school and parents' perceptions of their child's road-crossing ability were found to be significant predictors of parental discomfort (in letting their child walk). Younger children and children who spent less time walking were more likely to be supervised by an adult.

Conclusions: Many South African schoolchildren have to navigate the roads without adult supervision from a young age. Caregivers, especially in low-income settings, often have limited options with regard to getting their child to school safely. Regardless of the child's age and gender, the time that they spend on the roads is an important factor for parents in terms of pedestrian safety.     

Geo-spatial and log-linear analysis of pedestrian and bicyclist crashes involving school-aged children

PROBLEM: There is a growing concern with the safety of school-aged children. This study identifies the locations of pedestrian/bicyclist crashes involving school-aged children and examines the conditions when these crashes are more likely to occur. METHOD: The 5-year records of crashes in Orange County, Florida where school-aged children were involved were used. The spatial distribution of these crashes was investigated using the Geographic Information Systems (GIS) and the likelihoods of crash occurrence under different conditions were estimated using log-linear models. RESULTS: A majority of school-aged children crashes occurred in the areas near schools. Although elementary school children were generally very involved, middle and high school children were more involved in crashes, particularly on high-speed multi-lane roadways. Driver's age, gender, and alcohol use, pedestrian's/bicyclist's age, number of lanes, median type, speed limits, and speed ratio were also found to be correlated with the frequency of crashes. DISCUSSION: The result confirms that school-aged children are exposed to high crash risk near schools. High crash involvement of middle and high school children reflects that middle and high schools tend to be located near multi-lane high-speed roads. IMPACT ON INDUSTRY: The pedestrian's/bicyclist's demographic factors and geometric characteristics of the roads adjacent to schools associated with school children's crash involvement are of interest to school districts.     

Dangerous student car drop-off behaviors and child pedestrian–motor vehicle collisions: An observational study

Objectives: The objective of this study was to examine the association between dangerous student car drop-off behaviors and historical child pedestrian–motor vehicle collisions (PMVCs) near elementary schools in Toronto, Canada.

Methods: Police-reported child PMVCs during school travel times from 2000 to 2011 were mapped within 200 m of 118 elementary schools. Observers measured dangerous student morning car drop-off behaviors and number of children walking to school during one day in 2011. A composite score of school social disadvantage was obtained from the Toronto District School Board. Built environment and traffic features were mapped and included as covariates. A multivariate Poisson regression was used to model the rates of PMVC/number of children walking and dangerous student car drop-off behaviors, adjusting for the built environment and social disadvantage.

Results: There were 45 child PMVCs, with 29 (64%) sustaining minor injuries resulting in emergency department visits. The mean collision rate was 2.9/10,000 children walking/year (SD = 6.7). Dangerous drop-off behaviors were observed in 104 schools (88%). In the multivariate analysis, each additional dangerous drop-off behavior was associated with a 45% increase in collision rates (incident rate ratio [IRR] = 1.45, 95% confidence interval [CI], 1.02, 2.07). Higher speed roads (IRR = 1.27, 95% CI, 1.13, 1.44) and social disadvantage (IRR = 2.99, 95% CI, 1.03, 8.68) were associated with higher collision rates.

Conclusions: Dangerous student car drop-off behaviors were associated with historical nonfatal child PMVC rates during school travel times near schools. Some caution must be taken in interpreting these results due small number of events and limitations in the data collection, because collision data were collected historically over a 12-year period, whereas driving behavior was only observed on a single day in 2011. Targeted multifaceted intervention approaches related to the built environment, enforcement, and education could address dangerous drop-off behaviors near schools to reduce child PMVCs and promote safe walking to school.     

Should 'Cyrus the Centipede' take a hike? Effects of exposure to a pedestrian safety program on children's safety knowledge and self-reported behaviors

INTRODUCTION: We report the first evaluation of the popular "Cyrus the Centipede" child pedestrian safety program. METHOD: A pre-test/post-test control versus experimental condition design was used to assess Cyrus' impact on third graders' pedestrian safety knowledge, and self-reported pedestrian behaviors. RESULTS: Although some beneficial effects were observed, the program was not reliably effective. In particular, the impact of exposure to Cyrus was strongly influenced by the individual teacher who delivered it, likely due to the highly unstructured nature of the curriculum. SUMMARY: We suggest that: (a) the effectiveness and reliability of such programs be demonstrated before they are widely adopted; and (b) programs that focus on training children in actual or simulated traffic environments may be more effective than those that primarily focus on teaching safety facts and rules.     

Gender differences in children's pedestrian behaviors: Developmental effects

IntroductionAll child pedestrians are vulnerable to road traffic injuries, but there is evidence that boys may be at greater risk than girls, at least among some age groups.MethodTo create effective intervention programs, research on how boys and girls of particular ages behave as pedestrians, and whether there are gender differences that increase risk for particular genders at particular ages, is needed. In this study, 255 boys and 235 girls in grade 1 through 6 from two primary schools in Nantong city, China, were unobtrusively videotaped when walking to school in the morning. Videotapes were reviewed and coded for seven pedestrian safety behaviors, including activities related to crossing streets (walking instead of running/hopping, observing traffic, using the crosswalk instead of walking outside the crosswalk, and keeping close to an accompanying adult) and those related to walking alongside busy streets (walking instead of running/hopping on the sidewalk, not playing on the sidewalk, walking alone instead of walking side-by-side with a partner).ResultsResults revealed that as a whole, boys played on the sidewalk more often than girls (p < 0.01) and crossed with an accompanying adult more than girls (p < 0.05), while girls walked side-by-side with partners more often than boys (p < 0.05). With a few exceptions, boys and girls in the younger grades (1–2) as well as those in the older grades (5–6) behaved fairly similarly as pedestrians, but boys and girls in the middle grades (3–4) presented with several significant gender-based differences. In the middle grades, boys watched traffic more than girls while crossing (p < 0.01); ran, hopped and played on the sidewalk more often than girls (p < 0.05); and walked side-by-side less often with partners than girls (p < 0.05). We also detected different gender-based trends in the development of pedestrian skills. With increasing age, girls performed more safely in pedestrian tasks, but boys did not show a similar developmental trend.ConclusionsWe conclude that boys and girls exhibit different characteristics in their pedestrian behaviors and discuss implications for prevention.     

Local vs. national: Epidemiology of pedestrian injury in a mid-Atlantic city

Objective: Understanding pedestrian injury trends at the local level is essential for program planning and allocation of funds for urban planning and improvement. Because we hypothesize that local injury trends differ from national trends in significant and meaningful ways, we investigated citywide pedestrian injury trends to assess injury risk among nationally identified risk groups, as well as identify risk groups and locations specific to Baltimore City.

Methods: Pedestrian injury data, obtained from the Baltimore City Fire Department, were gathered through emergency medical services (EMS) records collected from January 1 to December 31, 2014. Locations of pedestrian injuries were geocoded and mapped. Pearson's chi-square test of independence was used to investigate differences in injury severity level across risk groups. Pedestrian injury rates by age group, gender, and race were compared to national rates.

Results: A total of 699 pedestrians were involved in motor vehicle crashes in 2014—an average of 2 EMS transports each day. The distribution of injuries throughout the city did not coincide with population or income distributions, indicating that there was not a consistent correlation between areas of concentrated population or concentrated poverty and areas of concentrated pedestrian injury. Twenty percent (n = 138) of all injuries occurred among children age ≤14, and 22% (n = 73) of severe injuries occurred among young children. The rate of injury in this age group was 5 times the national rate (Incident Rate Ratio [IRR] = 4.81, 95% confidence interval [CI], [4.05, 5.71]). Injury rates for adults ≥65 were less than the national average.

Conclusions: As the urban landscape and associated pedestrian behavior transform, continued investigation of local pedestrian injury trends and evolving public health prevention strategies is necessary to ensure pedestrian safety.     

Socioeconomic status and the occurrence of non-fatal child pedestrian injury: Results from a cross-sectional survey

This study is to examine the contribution of socioeconomic status (SES) to the risk of nonfatal pedestrian injury among children. The sample was obtained from two urban cities of China using multi-staged randomized sampling. Information was collected by respondents’ reporting using self-administrative way in the classroom under the guidance of interviewers. A logistic regression analysis was applied to examine the associations between SES and nonfatal children pedestrian injury. The results showed that boys and children aged 10 had significantly increased odds of suffering nonfatal pedestrian injury. Migrant children were at higher risk of being injured. Students whose mothers’ educational levels were either less than secondary school or postgraduate were more likely to sustain injury. Children who were from wealthier families or poorer families easily suffered from injury compared to children from middle families. Children living with grandparents, or siblings, or a single father, or a single mother were all at increased risk of injury. The possible causes or pathways of these SESs’ impacts on pedestrian injury were explored in discussion. This study suggests that SESs are important determinants of nonfatal pedestrian injury among children in China.     

Head injuries in child pedestrian accidents--in-depth case analysis and reconstructions

OBJECTIVE: The aim of this study was to investigate head injuries, injury risks, and corresponding tolerance levels of children in car-to--child pedestrian collisions. METHODS: An in-depth accident analysis was carried out based on 23 accident cases involving child pedestrians. These cases were collected with detailed information about pedestrians, cars, and road environments. All 23 accidents were reconstructed using the MADYMO program with mathematical models of passenger cars and child pedestrians developed at Chalmers University of Technology. The contact properties of the car models were derived from the European New Car Assessment Program (EuroNCAP) subsystem tests. RESULTS: The accident analysis demonstrated that the head was the most frequently and severely injured body part of child pedestrians. Most accidents occurred at impact speeds lower than 40 km/h and 98% of the child pedestrians were impacted from the lateral direction. The initial postures of children at the moment of impact were identified. Nearly half (47%) of the children were running, which was remarkable compared with the situation of adult pedestrians. From accident reconstructions it was found that head impact conditions and injury severities were dependent on the shape and stiffness of the car front, impact velocity, and stature of the child pedestrian. Head injury criteria and corresponding tolerance levels were analyzed and discussed by correlating the calculated injury parameters with the injury outcomes in the accidents. CONCLUSIONS: Reducing head injuries should be set as a priority in the protection of child pedestrians. HIC is an important injury criterion for predicting the risks of head injuries in child pedestrian accidents. The tolerance level of head injuries can have a considerable variation due to individual differences of the child pedestrians. By setting a suitable speed limit and improving the design of car front, the head injury severities of child pedestrians can be reduced.     

How do children learn to cross the street? The process of pedestrian safety training

Objective: Pedestrian injuries are a leading cause of child death and may be reduced by training children to cross streets more safely. Such training is most effective when children receive repeated practice at the complex cognitive–perceptual task of judging moving traffic and selecting safe crossing gaps, but there is limited data on how much practice is required for children to reach adult levels of functioning. Using existing data, we examined how children's pedestrian skills changed over the course of 6 pedestrian safety training sessions, each composed of 45 crossings within a virtual pedestrian environment.

Methods: As part of a randomized controlled trial on pedestrian safety training, 59 children ages 7–8 crossed the street within a semi-immersive virtual pedestrian environment 270 times over a 3-week period (6 sessions of 45 crossings each). Feedback was provided after each crossing, and traffic speed and density were advanced as children's skill improved. Postintervention pedestrian behavior was assessed a week later in the virtual environment and compared to adult behavior with identical traffic patterns.

Results: Over the course of training, children entered traffic gaps more quickly and chose tighter gaps to cross within; their crossing efficiency appeared to increase. By the end of training, some aspects of children's pedestrian behavior was comparable to adult behavior but other aspects were not, indicating that the training was worthwhile but insufficient for most children to achieve adult levels of functioning.

Conclusions: Repeated practice in a simulated pedestrian environment helps children learn aspects of safe and efficient pedestrian behavior. Six twice-weekly training sessions of 45 crossings each were insufficient for children to reach adult pedestrian functioning, however, and future research should continue to study the trajectory and quantity of child pedestrian safety training needed for children to become competent pedestrians.     

Impact of improving vehicle front design on the burden of pedestrian injuries in Germany,the United States,and India

Objective: European car design regulations and New Car Assessment Program (NCAP) ratings have led to reductions in pedestrian injuries. The aim of this study was to evaluate the impact of improving vehicle front design on mortality and morbidity due to pedestrian injuries in a European country (Germany) and 2 countries (the United States and India) that do not have pedestrian-focused NCAP testing or design regulations.

Methods: We used data from the International Road Traffic and Accident Database and the Global Burden of Disease project to estimate baseline pedestrian deaths and nonfatal injuries in each country in 2013. The effect of improved passenger car star ratings on probability of pedestrian injury was based on recent evaluations of pedestrian crash data from Germany. The effect of improved heavy motor vehicle (HMV) front end design on pedestrian injuries was based on estimates reported by simulation studies. We used burden of disease methods to estimate population health loss by combining the burden of morbidity and mortality in disability-adjusted life years (DALYs) lost.

Results: Extrapolating from evaluations in Germany suggests that improving front end design of cars can potentially reduce the burden of pedestrian injuries due to cars by up to 24% in the United States and 41% in India. In Germany, where cars comply with the United Nations regulation on pedestrian safety, additional improvements would have led to a 1% reduction. Similarly, improved HMV design would reduce DALYs lost by pedestrian victims hit by HMVs by 20% in each country. Overall, improved vehicle design would reduce DALYs lost to road traffic injuries (RTIs) by 0.8% in Germany, 4.1% in the United States, and 6.7% in India.

Conclusions: Recent evaluations show a strong correlation between Euro NCAP pedestrian scores and real-life pedestrian injuries, suggesting that improved car front end design in Europe has led to substantial reductions in pedestrian injuries. Although the United States has fewer pedestrian crashes, it would nevertheless benefit substantially by adopting similar regulations and instituting pedestrian NCAP testing. The maximum benefit would be realized in low- and middle-income countries like India that have a high proportion of pedestrian crashes. Though crash avoidance technologies are being developed to protect pedestrians, supplemental protection through design regulations may significantly improve injury countermeasures for vulnerable road users.     

Factors associated with concussion symptom knowledge and attitudes towards concussion care-seeking among parents of children aged 5–10 years

Background: Understanding parents’ concussion-related knowledge and attitudes will contribute to the development of strategies that aim to improve concussion prevention and sport safety for elementary school children. This study investigated the association between parent- and child-related factors and concussion symptom knowledge and care-seeking attitudes among parents of elementary school children (aged 5–10 years). Methods: Four hundred parents of elementary school children completed an online questionnaire capturing parental and child characteristics; concussion symptom knowledge (25 items, range = 0–50; higher = better knowledge); and concussion care-seeking attitudes (five 7-point scale items, range = 5–35; higher = more positive attitudes). Multivariable ordinal logistic regression models identified predictors of higher score levels. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) excluding 1.00 were deemed statistically significant. Results: Select parent and child characteristics were associated with higher score levels for both outcomes. For example, odds of better knowledge level in parents were higher with increased age (10-year increase aOR = 1.59; 95% CI = 1.10–2.28), among females (aOR = 3.90; 95% CI = 2.27–6.70), and among white/non-Hispanics (aOR = 1.79; 95%CI = 1.07–2.99). Odds of more positive concussion care-seeking attitude levels were higher among parents with a college degree (aOR = 1.98; 95%CI = 1.09–3.60). Child sports participation was not associated with higher score levels for either outcome. Conclusions: Certain elementary school parent characteristics were associated with parents’ concussion symptom knowledge and care-seeking attitudes. While the findings suggest providing parents with culturally and demographically relevant concussion education might be helpful, they also emphasize the importance of ensuring education/prevention regardless of their children’s sports participation. Practical Applications: Pediatric healthcare providers and elementary schools offer an optimal community-centered location to reach parents with this information within various communities.     

Evaluation of give kids a boost: A school-based program to increase booster seat use among urban children in economically disadvantaged areas

Objective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.

Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P₀), 1–4 weeks after the completion of project implementation (P₁), and 4–5 months later (P₂). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.

The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.

The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.

Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P₀ and P₁ (P₀ = 4.8%, P₁ = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P₂ time period (P₂ = 25.7%; P < .001, for P₀ vs. P₂) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P₀ time period and compared to the comparison schools.

Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings.     

Children’s fear in traffic and its association with pedestrian decisions

Introduction: Research on risk for child pedestrian injury risk focuses primarily on cognitive risk factors, but emotional states such as fear may also be relevant to injury risk. The current study examined children's perception of fear in various traffic situations and the relationship between fear perception and pedestrian decisions. Method: 150 children aged 6–12-years old made pedestrian decisions using a table-top road model. Their perceived fear in the pedestrian context was assessed. Results: Children reported greater emotional fear when they faced quicker traffic, shorter distances from approaching traffic, and red rather than green traffic signals. Children who were more fearful made safer pedestrian decisions in more challenging traffic situations. However, when the least risky traffic situation was presented, fear was associated with more errors in children’s pedestrian decisions: fearful children failed to cross the street when they could have done so safely. Perception of fear did not vary by child age, although safe pedestrian decisions were more common among the older children. Conclusions: Children’s emotional fear may predict risk-taking in traffic. When traffic situations are challenging to cross within, fear may appropriately create safer decisions. However, when the traffic situation is less risky, feelings of fear could lead to excessive caution and inefficiency. Practical applications: Child pedestrian safety interventions may benefit by incorporating activities that introduce realistic fear of traffic risks into broader safety lessons.     

Detection of the toughest: Pedestrian injury risk as a smooth function of age

Objective: Though it is common to refer to age-specific groups (e.g., children, adults, elderly), smooth trends conditional on age are mainly ignored in the literature. The present study examines the pedestrian injury risk in full-frontal pedestrian-to–passenger car accidents and incorporates age—in addition to collision speed and injury severity—as a plug-in parameter.

Methods: Recent work introduced a model for pedestrian injury risk functions using explicit formulae with easily interpretable model parameters. This model is expanded by pedestrian age as another model parameter. Using the German In-Depth Accident Study (GIDAS) to obtain age-specific risk proportions, the model parameters are fitted to the raw data and then smoothed by broken-line regression.

Results: The approach supplies explicit probabilities for pedestrian injury risk conditional on pedestrian age, collision speed, and injury severity under investigation. All results yield consistency to each other in the sense that risks for more severe injuries are less probable than those for less severe injuries. As a side product, the approach indicates specific ages at which the risk behavior fundamentally changes. These threshold values can be interpreted as the most robust ages for pedestrians.

Conclusions: The obtained age-wise risk functions can be aggregated and adapted to any population. The presented approach is formulated in such general terms that in can be directly used for other data sets or additional parameters; for example, the pedestrian's sex. Thus far, no other study using age as a plug-in parameter can be found.     

“If I know when you will arrive,I will let you walk to school:” The role of information technology

Introduction: Providing a sense of supervision for parents may facilitate their children’s involvement in physical outdoor activities, such as walking to school. Information technology (IT) solutions could bring more parental supervision, which in turn has the potential to enhance the proportion of walking trips to school. This study aimed to examine the role of a proposed hypothetical IT solution that gives parents real-time information about children’s entrance to and exit from the school, for the intention of parents letting their children walk to school. Method: A total of 820 questionnaires were distributed among pupils aged 7–9-years across 28 elementary schools to be completed by their parents (82% return rate). Results: Compared to the group of walking pupils, increased parental intention to let their children walk to school under the proposed solution could be explained by considerably more variables in the group of pupils who did not walk to school. The findings revealed that increased parental intention was higher among the walking pupils compared to the non-walking pupils. For the non-walking pupils, enhancement of walking facilities across the school area could potentiate the use of the proposed solution by the parents, which in turn may increase the proportion of walking on school trips. In addition, boy pupils, the pupils whose parents evaluated walking more favorable, those from lower socioeconomic backgrounds, and those living in close proximity to the school could more likely benefit by shifting from non-walking to walking modes of travel, after implementation of the solution.     

Personal injury recovery cost of pedestrian–vehicle collisions in New South Wales,Australia

Background: There is a need for routine estimates of injury recovery costs from pedestrian collisions using hospital separation records for economic evaluations.

Objective: To estimate the cost of injury recovery following pedestrian–vehicle collisions using the personal injury recover cost (PIRC) equation using key demographic and injury characteristics.

Method: An estimation of the costs of on-road pedestrian–vehicle collisions involving individuals who were injured and hospitalized in New South Wales (NSW), Australia, from 2002 to 2011 using the PIRC equation. The PIRC estimates individual injury recovery costs and does not include costs associated with property damage, vehicle repair, or rescue services. Individual recovery costs associated with severe traumatic brain injury (TBI) were estimated. The injured individual's mean, median, and total injury recovery costs are described for key demographic, injury, and crash characteristics.

Results: There were 9,781 pedestrians who were injured, costing an estimated total of $2.4 billion in personal injury recovery costs, an annual cost of $243 million. Males had a total injury recovery cost 1.7 times higher than females. The median injury recovery cost decreased with increasing age. TBI ($248,491) and spinal cord and vertebral column injuries ($264,103) had the highest median injury recovery costs for the body region of the most severe injury. TBI accounted for 22.6% of the total injury recovery costs for the most severe injury sustained. Just over one third of pedestrians sustained 4 or more injuries, with a median cost of $243,992, which was 1.6 times higher than the cost for a pedestrian who sustained a single injury ($153,682).

Conclusions: Personal injury recovery costs following pedestrian–vehicle collisions where a pedestrian is injured are substantial in NSW. The PIRC equation enables the economic cost burden of road traffic injury to be calculated using hospital separation data. The PIRC enables comprehensive personal injury recovery costs to be estimated and would aid in economic evaluations of preventive strategies in road safety.     

A virtual test system representing the distribution of pedestrian impact configurations for future vehicle front-end optimization

Objectives: The purpose of this study is to define a computationally efficient virtual test system (VTS) to assess the aggressivity of vehicle front-end designs to pedestrians considering the distribution of pedestrian impact configurations for future vehicle front-end optimization. The VTS should represent real-world impact configurations in terms of the distribution of vehicle impact speeds, pedestrian walking speeds, pedestrian gait, and pedestrian height. The distribution of injuries as a function of body region, vehicle impact speed, and pedestrian size produced using this VTS should match the distribution of injuries observed in the accident data. The VTS should have the predictive ability to distinguish the aggressivity of different vehicle front-end designs to pedestrians.

Methods: The proposed VTS includes 2 parts: a simulation test sample (STS) and an injury weighting system (IWS). The STS was defined based on MADYMO multibody vehicle to pedestrian impact simulations accounting for the range of vehicle impact speeds, pedestrian heights, pedestrian gait, and walking speed to represent real world impact configurations using the Pedestrian Crash Data Study (PCDS) and anthropometric data. In total 1,300 impact configurations were accounted for in the STS. Three vehicle shapes were then tested using the STS. The IWS was developed to weight the predicted injuries in the STS using the estimated proportion of each impact configuration in the PCDS accident data. A weighted injury number (WIN) was defined as the resulting output of the VTS. The WIN is the weighted number of average Abbreviated Injury Scale (AIS) 2+ injuries recorded per impact simulation in the STS. Then the predictive capability of the VTS was evaluated by comparing the distributions of AIS 2+ injuries to different pedestrian body regions and heights, as well as vehicle types and impact speeds, with that from the PCDS database. Further, a parametric analysis was performed with the VTS to assess the sensitivity of the injury predictions to changes in vehicle shape (type) and stiffness to establish the potential for using the VTS for future vehicle front-end optimization.

Results: An STS of 1,300 multibody simulations and an IWS based on the distribution of impact speed, pedestrian height, gait stance, and walking speed is broadly capable of predicting the distribution of pedestrian injuries observed in the PCDS database when the same vehicle type distribution as the accident data is employed. The sensitivity study shows significant variations in the WIN when either vehicle type or stiffness is altered.

Conclusions: Injury predictions derived from the VTS give a good representation of the distribution of injuries observed in the PCDS and distinguishing ability on the aggressivity of vehicle front-end designs to pedestrians. The VTS can be considered as an effective approach for assessing pedestrian safety performance of vehicle front-end designs at the generalized level. However, the absolute injury number is substantially underpredicted by the VTS, and this needs further development.