Reduction of pediatric pedestrian hazardous road conditions in a school drop-off zone using video review.

BACKGROUND: In 2012, 76,000 pedestrians were struck by motor vehicles. This resulted in 20% of all pediatric mortalities between the ages of 5 and 15. We hypothesize that children are exposed to increased risk as pedestrians to motor vehicle injury when arriving to school and that identification of these hazards would improve targeting of injury prevention efforts.

METHODS: Within a county containing 355 public schools, we identified a primary school with 588 students located in an urban setting with concerns for a high-risk traffic environment. Field surveys observed traffic patterns and established an optimal surveillance period 30 minutes before school. Three observation periods, from two discreet and blinded locations, were conducted from January to March 2016. Videos were evaluated by two independent reviewers to identify and score quantifiable hazards. Three controlled observations were conducted on non-school days, followed by three post-intervention observations from October to December 2016. Comparison was made using Student's t test. Data was analyzed using SAS version 9.4 (SAS Institute Inc., Cary, NC).

RESULTS: We identified nine safety hazards including double parking (29.3 ± 5.5), dropping off in a bus stop (23.3 ± 7.6), and jaywalking (9.3 ± 3.1). Combining all hazards seen in each observation resulted in an overall hazard average of 83.0 ± 3.6 events/period. Comparing control periods to school observation identified significantly increased hazard events on school days (p < 0.0001). Targeted safety intervention demonstrated a 26% reduction in hazard events (p < 0.0005).

CONCLUSION: We identified the most common hazards associated with children arriving at a primary school in an urban setting, used our analysis to develop an intervention, and demonstrated the impact of our intervention. Our novel use of video review to identify hazards provides a metric against which the impact of pedestrian road safety interventions might be measured.

LEVEL OF EVIDENCE: Epidemiological, level II; Therapeutic, level IV.