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Am J Forensic Med Pathol 2020 Mar;41(1):52-55

Department of Pathology and Laboratory Medicine, London Health Sciences Centre and Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Characteristic injury patterns have been described in pedestrians struck by motor vehicles. The common injury pattern seen in upright pedestrians consists of a triad of head, pelvis, and lower extremity trauma. There are several factors such as vehicular type, design, mass and speed, and impact surfaces that influence the type and distribution of these injuries. Read More

Traffic Inj Prev 2019 ;20(sup1):S171-S176

a Virginia Tech, Center for Injury Biomechanics , Blacksburg , Virginia.

The objective of this research study is to estimate the benefit to pedestrians if all U.S. cars, light trucks, and vans were equipped with an automated braking system that had pedestrian detection capabilities. Read More

Traffic Inj Prev 2019 ;20(sup1):S1-S6

b Faculty of System Design, Tokyo Metropolitan University , Hino , Tokyo , Japan.

This study aimed to investigate the situational characteristics of fatal pedestrian accidents involving vehicles traveling at low speeds in Japan. We focused on vehicles with 4 or more wheels. Such characteristics included daytime or nighttime conditions, road type, vehicle behaviors preceding the accident, and vehicle impact locations. Read More

Chin J Traumatol 2019 Apr 11;22(2):63-68. Epub 2019 Mar 11.

Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China. Electronic address:

Purpose: Vehicle-pedestrian conflicts are common at road intersections when traffic lights change. However, the impact of traffic light on transportation safety and efficiency remains poorly understood.

Methods: A two-stage study was used to survey the proportion of intersections with conflicting traffic lights and the related transportation efficiency and safety were evaluated as well. Read More

J Safety Res 2018 12 27;67:37-44. Epub 2018 Sep 27.

Insurance Institute for Highway Safety, United States.

Introduction: Pedestrian fatalities increased 46% in the United States during 2009-2016. This study identified circumstances under which the largest increases in deaths occurred during this period.

Method: Annual counts of U. Read More

World J Cardiol 2018 Jul;10(7):49-51

Surgery Working Group, Society of Junior Doctors, Athens 15123, Greece.

Data from the last 50 years suggest that pediatric patients typically suffer cardiothoracic injuries following blunt traumatic force (70%) in the setting of either motor vehicle crashes (53.5%) or vehicle-pedestrian accidents (18.2%). Read More

Del Med J 2016 Jul;88(7):206-211

Background: Pediatric pedestrian motor vehicle-associated of injuries correlated with a particular census tract's trauma is a significant public health concern for children. demographic composition. GIS mapping software was used We aimed to use geographic information systems (GIS) to examine the relationship between motor vehicle pedestrian injuries in children and the demographics of the region in which they occurred for the state of Delaware. Read More

J Pediatr Orthop B 2017 Jul;26(4):350-357

Department of Orthopaedic Surgery, University of South Alabama, Mobile, Alabama, USA.

Femoral neck and pelvic fractures are rarely encountered in the pediatric population secondary to the resilient nature of the immature skeleton. Both fracture types usually result from high-energy blunt trauma including motor vehicle collisions, motor vehicle-pedestrian accidents, and falls from height. Considerable studies have been published on the natural history, management, and complications of pediatric pelvis and femoral neck fractures. Read More

Accid Anal Prev 2015 Jun 24;79:56-69. Epub 2015 Mar 24.

Department of Mechanical and Manufacturing Engineering, Parsons Building, Trinity College Dublin, College Green, Dublin 2, Ireland.

Accident data have shown that in pedestrian accidents with high-fronted vehicles (SUVs and vans) the risk of pedestrian head injuries from the contact with the ground is higher than with low-fronted vehicles (passenger cars). However, the reasons for this remain poorly understood. This paper addresses this question using multibody modelling to investigate the influence of vehicle front height and shape in pedestrian accidents on the mechanism of impact with the ground and on head ground impact speed. Read More

Rev Peru Med Exp Salud Publica 2014 Oct-Dec;31(4):721-4

Hospital San Vicente de Paul, Ibarra, Ecuador.

With the objective of describing mortality from traffic accidents in Bayamo, Cuba, in 2011 a review was performed of injured and deceased patients due to traffic accidents, recorded in the Hospital Carlos M. de Céspedes. Of the 1,365 injured patients treated in the emergency room, the predominant groups were individuals aged 25 to 44 years comprising 372 patients (27. Read More

Accid Anal Prev 2014 Oct 20;71:261-6. Epub 2014 Jun 20.

Autoliv Development AB, Autoliv Research, Wallentinsvägen 22, SE-44783 Vårgårda, Sweden.

Introduction: Technical systems that warn or brake for vehicle-pedestrian encounters reduce injuries more effectively the earlier an intervention is initiated. However, premature intervention can irritate drivers, leading to system deactivation and, consequently, no injury reduction whatsoever. It has been proposed that no intervention should be initiated as long as attentive drivers are within their comfort zones. Read More

Pediatrics 2014 May 7;133(5):776-84. Epub 2014 Apr 7.

Child Health Evaluative Sciences, and Health Policy Management and Evaluation, and Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Canada; Surgery.

Objectives: Initiatives to increase active school transportation are popular. However, increased walking to school could increase collision risk. The built environment is related to both pedestrian collision risk and walking to school. Read More

Traffic Inj Prev 2013 ;14(7):712-7

Chongqing Key Laboratory of Vehicle Crash/Bio-Impact and Traffic Safety, Department 4, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.

Objective: To investigate the relative likelihood of pedestrian head injuries based on person, vehicular, and environmental factors in China.

Methods: A team was established to collect passenger car-pedestrian accident cases occurring between 2006 and 2011 in Beijing, Shanxi Province, and Chongqing, China. Some key variables for person-, vehicle-, and environment-related factors on head injuries were analyzed using multivariate logistic regression analysis to determine relative risk/likelihood. Read More

Eur J Trauma Emerg Surg 2013 Aug 14;39(4):369-74. Epub 2012 Sep 14.

2nd Surgical Department and Unit of Surgical Oncology, "Korgialenio-Benakio", Red Cross Athens General Hospital, 115 26, Athens, Greece.

Purpose: In the absence of dedicated trauma centers, surgical emergency departments in hospitals assigned as trauma centers accept a huge load of trauma patients. In this audit, we aim to document and assess the epidemiologic data of trauma patients and their injuries in order to give a picture of the impact of trauma in the workload of a surgical department in the Greek healthcare system.

Methods: During a period of 2 years, we managed 6,041 trauma patients in the accident and emergency (A&E) department based on the Advanced Trauma Life Support (ATLS) protocols. Read More

Ulus Travma Acil Cerrahi Derg 2013 May;19(3):267-70

Department of Neurosurgery, Maltepe University Faculty of Medicine, İstanbul, Turkey.

Intracranial epidural haematomas are almost always secondary to head traumas and usually occur unilaterally. Bilateral intracranial epidural haematomas are rare, but the mortality is very high. In our case, we report a bilateral epidural haematoma in a 32 year old, HIV infected male patient who came to the emergency service with a head trauma because of a motor vehicle-pedestrian accident. Read More

Int J Inj Contr Saf Promot 2013 30;20(4):374-9. Epub 2012 Nov 30.

a Trauma Surgery Section, , Hamad General Hospital , Doha, Qatar.

Traffic-related pedestrian injuries (TRPI) are vulnerable to road users. In this study, we aimed to evaluate the demographic pattern of injury and outcome of TRPI. Patients with TRPI admitted between November 2007 and March 2010 to the only level 1 trauma centre in Qatar were included. Read More

Accid Anal Prev 2011 Sep 22;43(5):1624-34. Epub 2011 Apr 22.

Department of Civil Engineering and Applied Mechanics, McGill University, Canada.

This paper studies the influence of built environment (BE) - including land use types, road network connectivity, transit supply and demographic characteristics - on pedestrian activity and pedestrian-vehicle collision occurrence. For this purpose, a two-equation modeling framework is proposed to investigate the effect of built environment on both pedestrian activity and vehicle-pedestrian collision frequency at signalized intersections. Using accident data of ambulance services in the City of Montreal, the applicability of our framework is illustrated. Read More

ANZ J Surg 2007 Aug;77(8):682-5

Department of Pediatric Surgery, Faculty of Medicine, Trakya University, Edirne, Turkey.

Background: Although thoracic injuries are uncommon in children, their rate of morbidity and mortality is high. The aim of this study was to evaluate the clinical features of children with blunt chest injury and to investigate the predictive accuracy of their paediatric trauma scores (PTS).

Methods: Between September 1996 and September 2006, children with blunt thoracic trauma were evaluated retrospectively. Read More

Risk Anal 2007 Feb;27(1):125-36

Harvard Initiative for Global Health, Harvard University, Cambridge, MA 02138, USA.

We describe a risk-based analytical framework for estimating traffic fatalities that combines the probability of a crash and the probability of fatality in the event of a crash. As an illustrative application, we use the methodology to explore the role of vehicle mix and vehicle prevalence on long-run fatality trends for a range of transportation growth scenarios that may be relevant to developing societies. We assume crash rates between different road users are proportional to their roadway use and estimate case fatality ratios (CFRs) for the different vehicle-vehicle and vehicle-pedestrian combinations. Read More

Accid Anal Prev 2006 Nov 23;38(6):1064-70. Epub 2006 Jun 23.

Center for Injury Research and Policy, Columbus Children's Research Institute and Children's Hospital, Columbus, OH 43205, USA.

Objectives: To examine the potential association between disability and risk of vehicle-pedestrian and vehicle-bicyclist collisions among children.

Methods: Data from the 2002 National Transportation Availability and Use Survey for Persons with Disabilities (NTAUSPD) were analyzed.

Results: Among 5019 persons who completed the survey, there were a total of 687 children between 5-17 years of age, including 299 respondents with and 388 without disabilities. Read More

Injury 2006 May 14;37(5):416-22. Epub 2006 Feb 14.

Department of Social Medicine, School of Public Health, Tongji Medical College, Wuhan, China.

Objectives: To examine motor vehicle-pedestrian collision injuries resulting in hospitalisation among children admitted into Wuhan Children's Hospital, The People's Republic of China.

Methods: From the 1993 to 2004 inpatient data of Wuhan Children's Hospital, we identified injury cases from motor vehicle traffic crashes among children aged 18 years or less using the discharge diagnosis defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). We examined characteristics of injuries from motor vehicle traffic crashes (ICD-9-CM = E810-E819) and then calculated the proportion of injuries from motor vehicle-pedestrian collisions (ICD-9-CM = E814) among all hospitalisations for childhood injuries (ICD-9-CM = 800-959). Read More

Pediatr Emerg Care 2004 Sep;20(9):569-73

Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

Objectives: Motor vehicle-pedestrian crashes are one of the leading causes of serious injury in children. Prior studies have focused on child and traffic factors contributing to these crashes. The objective of the current study was to examine the role of driving conditions on the occurrence of motor vehicle crashes involving child pedestrians. Read More

Traffic Inj Prev 2003 Dec;4(4):355-7

Division of Economics, University of Natal, Durban, South Africa.

A study of the pedestrian casualties and fatalities in road traffic crashes in Durban, a South African municipality, for 1999 was undertaken using official road traffic accident data. The pedestrians age 25 to 44, although only 23.9% of the population, were 39. Read More

Traffic Inj Prev 2003 Mar;4(1):74-82

Honda R&D Co, Ltd, Tochigi R&D Center, Tochigi, Japan.

For the evaluation of pedestrian protection, the European Enhanced Vehicle-Safety Committee Working Group 17 report is now commonly used. In the evaluation of head injuries, the report takes into account only the hood area of the vehicle. But recent pedestrian accident data has shown the injury source for head injury changing to the windshield and A-pillar from the hood. Read More

Accid Anal Prev 2003 Nov;35(6):927-40

Nissan Motor Company Ltd., 1, Natsushima-cho, Yokosuka-shi, Kanagawa 237-8523, Japan.

Bicyclist and pedestrian injuries in collisions with vehicles in Japan were investigated based on national and in-depth accident data analyses and mathematical simulations. In an impact with a bonnet-type vehicle, a bicyclist slides over the bonnet of the vehicle, behavior that is not observed for pedestrians. As a result, the bicyclist's head tends to strike a bonnet-type vehicle at a more rearward location in comparison with pedestrians. Read More

Inj Prev 2002 Dec;8(4):264-7

Department of Pediatrics, Harborview Medical Center (MS 359774), 325 9th Avenue, Seattle, WA 98104, USA.

In contrast to the steady reduction in mortality and morbidity from collisions involving motor vehicle occupants, relatively little progress has been made in controlling motor vehicle/pedestrian collisions. Engineering modifications are the most effective means of reducing such collisions, but mainly because of their cost, and public apathy about pedestrian safety, are too rarely employed. A modest experiment in community action was undertaken by attempting to induce the authorities of 10 small cities to apply for state funds to create a single model pedestrian refuge in their respective communities. Read More

Accid Anal Prev 1999 Sep;31(5):505-14

University of North Carolina, Highway Safety Research Center, Chapel Hill 27599-3430, USA.

Information on 2558 persons treated for injuries incurred while bicycling or walking was collected from eight hospital emergency departments over approximately a one-year time period. The emergency departments represented a mix of urban and suburban/rural sites in three states--California, New York, and North Carolina. The data were collected on special survey forms and included detailed information about the location of the injury event. Read More

J Bone Joint Surg Am 1999 Apr;81(4):500-9

The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.

Background: Fractures of the femoral shaft in children are caused by major musculoskeletal trauma and result in high direct and indirect medical costs. To date, the American literature has focused on treatment options and outcomes, but the epidemiology of these injuries has been generalized from Scandinavian studies reported in the 1970s and early 1980s. The goals of the current study were (1) to determine the age, gender, and race-specific rates and mechanisms of fractures of the femoral shaft in children in a large United-States-based population and (2) to identify associations between the rates of these fractures and multiple sociodemographic indicators. Read More

J Vasc Surg 1994 Sep;20(3):419-24; discussion 424-5

Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235.

Purpose: The purpose of this study was to determine the contribution of blunt vascular trauma to death and disability in children.

Methods: We reviewed the medical records of 41 patients aged 17 years and younger requiring operative intervention for 48 blunt vascular injuries during the past 18 years.

Results: Eight patients had arterial injuries (seven brachial, one superficial femoral) associated with orthopedic trauma resulting from falls. Read More

J Forensic Sci 1994 Jan;39(1):107-22

Department of Pathology, Victoria Hospital, London, Ontario, Canada.

A retrospective analysis of 89 fatalities with skull fracture resulting from motor vehicle-pedestrian and various single passenger car frontal, side, rear and rollover collisions was done. Passenger compartment intrusion and occupant ejection were responsible for most, but not all, cranial fractures occurring in impacted motor vehicles. Victims of frontal collisions usually were unrestrained; however, a majority of individuals in cars hit by heavy trucks were wearing seatbelts. Read More

Am J Forensic Med Pathol 1993 Sep;14(3):185-6

Bexar County Forensic Science Center, San Antonio, TX 78207.

Eighty-five fatal motor vehicle-pedestrian accidents involving adults were reviewed in order to establish the relationship of impact speed to amputation of limbs, atlanto-occipital dislocation of the spine, and distance a body is thrown by a vehicle from point of impact to point of rest. In five cases, there was amputation of a limb, in two, transection of the torso. All occurred at highway speeds (> 55 mph). Read More

Accid Anal Prev 1992 Jun;24(3):217-25

Psychology Department, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.

The purpose of this experiment was to evaluate the effects of signs reading "STOP HERE FOR PEDESTRIANS" alone and in conjunction with advance stop lines on pedestrian safety at multilane crosswalks with pedestrian-activated amber flashing lights. Motorist and pedestrian behaviors measured throughout this experiment included the occurrence of various types of motor vehicle-pedestrian conflicts; the distance that motorists stopped before the crosswalk when yielding to pedestrians; and the percentage of motorists yielding to pedestrians. The introduction of the sign alone 50 feet (15. Read More

J Trauma 1991 Aug;31(8):1110-5

Connecticut Childhood Injury Prevention Center, Hartford 06115.

Linked multiple data sources were analyzed to provide a population-based collision and injury severity profile among pedestrians under 20 years of age struck by a motor vehicle during 1986-1987 in Hartford, Connecticut. Data sources included police accident reports, medical examiner records, and hospital charts. There were 234 motor vehicle-pedestrian collisions reported to the police in the study period. Read More

Ann Surg 1991 Jun;213(6):532-8; discussion 538-9

Department of Surgery, University of Mississippi Medical Center, Jackson 39216.

Pelvic hemorrhage has been implicated as the cause of death in 50% of patients who die following pelvic fractures. To establish correlates of morbidity and mortality from pelvic fractures due to blunt trauma, we reviewed 236 patients treated during 4 years. The average age of the 144 men and 92 women was 31. Read More

South Med J 1991 Mar;84(3):342-8

Southeast Child Safety Institute, Children's Hospital of Alabama, Birmingham 35233.

Mortality data traditionally have been used to describe the epidemiology of childhood injury. Fatal outcomes, however, represent less than 1% of injury events and thus provide a limited characterization of the problem. Future epidemiologic study resulting in injury prevention depends upon the development of morbidity-based injury surveillance systems. Read More

Am J Emerg Med 1989 Jul;7(4):387-90

Division of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque 87131.

Elderly pedestrians struck by motor vehicles have the highest mortality rate of all pedestrian injury victims. One thousand eighty-two motor vehicle-pedestrian accidents occurring in a metropolitan area over a 5-year period were studied. Age-specific injury rates and fatality rates were evaluated with respect to the injury severity scores (ISS) for all fatally injured autopsied pedestrians. Read More

Arch Surg 1988 Nov;123(11):1320-7

Department of Surgery, Harborview Medical Center, University of Washington, Seattle 98104.

Two hundred forty consecutive patients admitted for operative treatment of an open fracture of the arm or leg were followed up prospectively for the development of fracture infection. The independent risk of fracture infection was increased in patients with grade IIIB or IIIC fractures, internal or external fixation, lower-leg fracture, any blood transfusion, or injuries resulting from motorcycle accidents or motor vehicle-pedestrian accidents. By stepwise multivariate logistic regression, the most significant risk factors were the grade of the fracture, internal or external fixation, and fractures of the lower leg. Read More

Am J Dis Child 1988 Oct;142(10):1048-51

Department of Pediatrics, University of Maryland Medical System, Baltimore 21201.

Accidents represent the leading cause of morbidity in the adolescent age group. Closed head injuries (CHI) sustained in such accidents are frequently associated with cognitive deficits. The intent of this study was to explore the neuropsychological functioning of adolescents with CHI. Read More

J Trauma 1983 Aug;23(8):691-6

Since 1975, more than one thousand children with life-threatening injuries have been preferentially transported to our statewide Regional Pediatric Trauma Center by helicopter or city ambulance. Initial care is provided by emergency medical technicians with special instruction in the handling of pediatric trauma. More than half the children admitted to our service were injured in motor vehicle/pedestrian or motor vehicle/bicycle accidents. Read More

Int J Epidemiol 1981 Jun;10(2):145-53

Death and motor vehicle crash (MVC) rates per 1000 vehicles and kilometres travelled in Israel (1977) exceed those of all western countries, despite low numbers of young and intoxicated drivers. Increased casualties have resulted from expansion of driver and vehicle populations offsetting a decline in crash risk. Time data indicate casualty crash trends reflect trends in traffic volume, and that night time case fatality rates (CFR) are high. Read More