Agran P F, Winn D G, Anderson C L, Tran C, Del Valle C P
Pediatric Injury Prevention Research Group, University of California, Irvine 92697-5800, USA.
Pediatrics. 1996 Dec;98(6 Pt 1):1096-103.
To identify environmental risk factors on residential streets for pediatric pedestrian injuries.
The sample consisted of 39 Latino children 0 to 14 years of age injured as pedestrians on a street in the same block as their home and 62 randomly selected neighborhood control subjects matched to the case by city, age or year of birth, ethnicity, and gender. The cases were identified from a population-based hospital and coroner's office surveillance system established in north-central Orange County, CA. Neighborhood assessments were performed from 3:45 PM to 5 PM, a fairly active time for young pedestrians. The cases were compared with the controls using conditional logistic regressions; in this study design, the odds ratios were interpreted as estimates of the incidence rate ratios.
Children living in a multifamily residence had an incidence of injury greater than that of children living in single-family residence on a single lot (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.3-7.6). The ORs in the highest category were several times those in the lowest category for both parked vehicles (OR 9.6, 95% CI 2.6-36) and total number of pedestrians observed (OR 4.7, 95% CI 1.4-16). Vehicle parking, total pedestrians, vehicular traffic volume, and speed were examined in a multivariate model. The association of vehicles parked on the street with pedestrian injury risk remained significant. Unlike the crude results, progressively greater vehicular speed was associated with a marked increase in risk. Progressively higher vehicular traffic volume was associated with a progressively lower adjusted OR.
The results of this analysis would indicate that residential streets with a high proportion of multifamily residence, over 50% of the curb occupied with parked vehicles, and a large number of pedestrians observed in unenclosed areas should receive high priority for intervention programs to reduce pediatric pedestrian injuries. The analysis suggests that on these streets, measures to reduce the amount of street parking (thus increasing visibility) and reductions in vehicular speed should be considered to decrease pedestrian injuries.
确定住宅街道上导致儿童行人受伤的环境危险因素。
样本包括39名0至14岁在其家所在街区的街道上作为行人受伤的拉丁裔儿童，以及62名通过城市、年龄或出生年份、种族和性别与病例匹配的随机选择的社区对照对象。病例来自加利福尼亚州奥兰治县中北部建立的基于人群的医院和验尸官办公室监测系统。社区评估在下午3:45至5点进行，这是年轻行人相当活跃的时间段。使用条件逻辑回归将病例与对照进行比较；在本研究设计中，比值比被解释为发病率比的估计值。
居住在多户住宅中的儿童受伤发生率高于居住在单块地上的独栋住宅中的儿童（比值比[OR]3.1，95%置信区间[CI]1.3 - 7.6）。对于停放车辆（OR 9.6，95% CI 2.6 - 36）和观察到的行人总数（OR 4.7，95% CI 1.4 - 16），最高类别中的OR是最低类别中的几倍。在多变量模型中检查了车辆停放、行人总数、车辆交通量和速度。街道上停放的车辆与行人受伤风险之间的关联仍然显著。与粗略结果不同，车辆速度逐渐增加与风险显著增加相关。车辆交通量逐渐增加与调整后的OR逐渐降低相关。
该分析结果表明，多户住宅比例高、路缘超过50%被停放车辆占据且在无封闭区域观察到大量行人的住宅街道应在减少儿童行人受伤的干预项目中获得高度优先考虑。分析表明，在这些街道上，应考虑采取措施减少街道停车数量（从而提高能见度）并降低车辆速度以减少行人受伤。
