Rothman Linda, Howard Andrew, Buliung Ron, Macarthur Colin, Richmond Sarah A, Macpherson Alison
Faculty of Health-School of Kinesiology & Health Science York University, Norman Bethune College, 4700 Keele St., Room 337 Toronto, ON M3J 1P3, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave., Toronto M5G 1X8, Canada.
Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Ave., Toronto M5G 1X8, Canada.
Accid Anal Prev. 2017 Jan;98:252-258. doi: 10.1016/j.aap.2016.10.017. Epub 2016 Oct 19.
Child pedestrian-motor vehicle collisions (PMVCs) have decreased in Canada in the past 20 years. Many believe this trend is explained by the rise in automobile use for all travel. Initiatives to increase walking to school need to consider PMVC risk. Potential risk factors related to walking to school, the built environment and social factors were examined for schools with historically high child PMVC rates.
Child PMVCs (age 4-12 years) from 2000 to 2013 and built environment features were mapped within school attendance boundaries in the City of Toronto, Canada. Case and control schools were in the highest and lowest PMVC quartiles respectively. Observational counts of travel mode to school were conducted. Logistic regression evaluated walking to school, built environment and social risk factors for higher PMVC rates, stratified by geographic location (downtown vs. inner suburbs).
The mean PMVC rates were 18.8/10,000/year (cases) and 2.5/10,000/year (controls). One-way street density (OR=4.00), school crossing guard presence (OR=3.65) and higher social disadvantage (OR=1.37) were associated with higher PMVCs. Higher residential land use density had a protective effect (OR=0.56). More walking was not a risk factor. While several built environment risk factors were identified for the inner suburbs; only social disadvantage was a risk factor within older urban neighbourhoods.
Several modifiable environmental risk factors were identified for child PMVCs. More walking to school was not associated with increased PMVCs after controlling for the environment. School social disadvantage was associated with higher PMVCs with differences by geographic location. These results have important implications for the design of roadways around schools.
在过去20年里，加拿大儿童行人与机动车碰撞事故（PMVCs）有所减少。许多人认为，这一趋势可归因于所有出行方式中汽车使用量的增加。增加步行上学的倡议需要考虑PMVC风险。针对儿童PMVC发生率历史较高的学校，研究了与步行上学、建成环境和社会因素相关的潜在风险因素。
绘制了2000年至2013年加拿大多伦多市儿童（4至12岁）PMVCs事故情况以及学校出勤范围内的建成环境特征。病例学校和对照学校分别处于PMVC四分位数的最高和最低区间。对上学出行方式进行了观察计数。采用逻辑回归分析评估步行上学、建成环境和社会风险因素对较高PMVC发生率的影响，并按地理位置（市中心与内郊区）分层。
PMVC的平均发生率分别为每年18.8/10000（病例组）和每年2.5/10000（对照组）。单行道密度（OR=4.00）、学校过街警卫的存在（OR=3.65）和较高的社会劣势（OR=1.37）与较高PMVC发生率相关。较高的住宅用地密度具有保护作用（OR=0.56）。步行更多并非风险因素。虽然在内郊区确定了几个建成环境风险因素；但在老城区，只有社会劣势是一个风险因素。
确定了几个可改变的儿童PMVC环境风险因素。在控制环境因素后，步行上学更多与PMVC增加无关。学校的社会劣势与较高的PMVC发生率相关，且因地理位置而异。这些结果对学校周边道路设计具有重要意义。
