Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover (LSVRO) incidents involving children aged 0–15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries from the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study inclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk factors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5 years, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies identified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with LSVRO injury. Vehicles were most commonly driven by a family member, predominantly a parent. Conclusion. There are a number of modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been identified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance systems), housing design (physical separation of driveway and play areas), and behaviour (driver behaviour, supervision of young children) are discussed. 1. Introduction Low-speed vehicle runover (LSVRO) injuries have been variably categorized as “rollover,” “backover,” “driveway,” or other “nontraffic” pedestrian injuries. They predominantly occur in nontraffic (off-road) settings, but not exclusively so, and as such have different antecedents to high-speed vehicle and traffic-related pedestrian injuries. Investigation and reporting of off-road vehicular incidents vary by locality, and a lack of standardised definitions, coding, and reporting makes LSVRO incidents difficult to find in routine data sources. Previous studies on child pedestrian injuries have identified specific contexts and antecedents relating to vehicular, environmental, and behavioural factors [1]. Injuries in children result in a significant economic burden to the health system due to long-term sequelae and ongoing disability amongst survivors [2]. In addition to the economic cost, there are significant psychological impacts on parents and carers [3, 4]. LSVRO incidents carry a significant risk of head and neck injury and have a high case fatality [5–8] with a l0-fold increase in mortality in children under 5 years of age
References
[1]
A. Wazana, P. Krueger, P. Raina, and L. Chambers, “A review of risk factors for child pedestrian injuries: are they modifiable?” Injury Prevention, vol. 3, no. 4, pp. 295–304, 1997.
[2]
D. Eldridge, Injury Among Young Australians, Australian Institute of Health and Welfare, Canberra, Australia, 2008, http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442452801.
[3]
F. K. Winston, N. Kassam-Adams, C. Vivarelli-O'Neill et al., “Acute stress disorder symptoms in children and their parents after pediatric traffic injury,” Pediatrics, vol. 109, no. 6, article e90, 2002.
[4]
L. Wijngaards-de Meij, M. Stroebe, H. Schut et al., “Couples at risk following the death of their child: predictors of grief versus depression,” Journal of Consulting and Clinical Psychology, vol. 73, no. 4, pp. 617–623, 2005.
[5]
R. J. Brison, K. Wicklund, and B. A. Mueller, “Fatal pedestrian injuries to young children: a different pattern of injury,” The American Journal of Public Health, vol. 78, no. 7, pp. 793–795, 1988.
[6]
P. Robinson and T. Nolan, “Paediatric slow-speed non-traffic fatalities: Victoria, Australia, 1985–1995,” Accident Analysis and Prevention, vol. 29, no. 6, pp. 731–737, 1997.
[7]
M. L. Silen, E. R. Kokoska, D. G. Fendya, A. G. Kurkchubasche, T. R. Weber, and T. F. Tracy, “Rollover injuries in residential driveways: age-related patterns of injury,” Pediatrics, vol. 104, no. 1, article e7, 1999.
[8]
S. J. Fenton, E. R. Scaife, R. L. Meyers, K. W. Hansen, and S. D. Firth, “The prevalence of driveway back-over injuries in the era of sports utility vehicles,” Journal of Pediatric Surgery, vol. 40, no. 12, pp. 1964–1968, 2005.
[9]
D. A. Partrick, D. D. Bensard, E. E. Moore, M. D. Partington, and F. M. Karrer, “Driveway crush injuries in young children: a highly lethal, devastating, and potentially preventable event,” Journal of Pediatric Surgery, vol. 33, no. 11, pp. 1712–1715, 1998.
[10]
H. Kravitz and A. Korach, “Deaths due to car driveway accidents,” Illinois Medical Journal, vol. 126, article 688, 1964.
[11]
M. J. Bell, J. L. Ternberg, and R. J. Bower, “Low velocity vehicular injuries in children. “Run-over” accidents,” Pediatrics, vol. 66, no. 4, pp. 628–631, 1980.
[12]
D. G. Winn, P. F. Agran, and D. N. Castillo, “Pedestrian injuries to children younger than 5 years of age,” Pediatrics, vol. 88, no. 4, pp. 776–782, 1991.
[13]
A. J. A. Holland, R. W. Y. Liang, S. J. Singh, D. N. Schell, F. I. Ross, and D. T. Cass, “Driveway motor vehicle injuries in children,” Medical Journal of Australia, vol. 173, no. 4, pp. 192–195, 2000.
[14]
R. Stark, S. Lee, A. Neville, B. Putnam, and S. Bricker, “Common denominators in death from pediatric back-over trauma,” The American Surgeon, vol. 77, no. 10, pp. 1420–1422, 2011.
[15]
M. Shepherd, P. Austin, and J. Chambers, “Driveway runover, the influence of the built environment: a case control study,” Journal of Paediatrics and Child Health, vol. 46, no. 12, pp. 760–767, 2010.
[16]
C. Nhan, L. Rothman, M. Slater, and A. Howard, “Back-over collisions in child pedestrians from the canadian hospitals injury reporting and prevention program,” Traffic Injury Prevention, vol. 10, no. 4, pp. 350–353, 2009.
[17]
K. A. Pinkney, A. Smith, N. C. Mann, G. D. Mower, A. Davis, and J. M. Dean, “Risk of pediatric back-over injuries in residential driveways by vehicle type,” Pediatric Emergency Care, vol. 22, no. 6, pp. 402–407, 2006.
[18]
A. J. A. Holland, F. I. Ross, P. Manglick, F. E. Fahy, and D. T. Cass, “Driveway motor vehicle injuries in children: a prospective review of injury circumstances,” Medical Journal of Australia, vol. 184, no. 6, article 311, 2006.
[19]
Centers for Disease Control, “Non fatal motor-vehicle-related backover injuries among children—United States, 2001–2003,” Morbidity and Mortality Weekly Report, vol. 54, no. 6, pp. 144–146, 2005.
[20]
J. M. Mayr, C. Eder, J. Wernig, D. Zebedin, A. Berghold, and S. H. Corkum, “Vehicles reversing or rolling backwards: an underestimated hazard,” Injury Prevention, vol. 7, no. 4, pp. 327–328, 2001.
[21]
P. F. Agran, D. G. Winn, and C. L. Anderson, “Differences in child pedestrian injury events by location,” Pediatrics, vol. 93, no. 2, pp. 284–288, 1994.
[22]
I. Roberts, R. Norton, R. Dunn, I. Hassall, and T. Lee-Joe, “Environmental factors and child pedestrian injuries,” Australian Journal of Public Health, vol. 18, no. 1, pp. 43–46, 1994.
[23]
NSW Child Death Review Team, NSW Child Death Review Team Annual Report 2011, 2012, http://www.ombo.nsw.gov.au/news-and-publications/publications/annual-reports/nsw-child-death-review/nsw-child-death-review-team-annual-report-2011.
[24]
N. Baker and B. White, Low Speed Run Over Mortality, Child and Youth Mortality Review Committee, Wellington, New Zealand, 2011, http://staging.hqsc.sites.silverstripe.com/assets/CYMRC/Publications/low-speed-report.pdf.
[25]
B. Griffin, K. Watt, B. Wallis, L. Shields, and R. Kimble, “Paediatric low speed vehicle run-over fatalities in Queensland,” Injury Prevention, vol. 17, no. 1, pp. i10–i13, 2011.
[26]
R. W. Byard and L. L. Jensen, “Toddler run-overs—a persistent problem,” Journal of Forensic and Legal Medicine, vol. 16, no. 4, pp. 202–203, 2009.
[27]
Commission for Children and Young People and Child Guardian, Investigation into Low Speed Run-Overs in Queensland, Commission for Children and Young People and Child Guardian, Brisbane, Australia, 2007.
[28]
National Highway Traffic Safety Administration, Data Collection Study: Deaths and Injuries Resulting from Certain Non-Traffic and Non-Crash Events, National Highway Traffic Safety Administration, US Department of Transportation, Washington DC, USA, 2004, http://www.nhtsa.dot.gov/cars/problems/studies/nontraffic-noncrash/images/noncrash.pdf.
[29]
Queensland Injury Surveillance Unit, Low Speed Run-Overs of Young Children, Queensland Injury Surveillance Unit, Brisbane, Australia, 2003, http://www.qisu.org.au/.
[30]
T. Neeman, J. Wylie, R. Attewell, et al., Driveway Deaths: Fatalities of Young Children in Australia as a Result of Low-Speed Motor Vehicle Impacts, Department of Transport and Regional Services, Australian Transport Safety Bureau, 2002, http://www.infrastructure.gov.au/roads/safety/publications/2002/Driveway_deaths.aspx.
[31]
A. Williamson, P. Irvine, and S. Sadural, Analysis of Motor Vehicle-Related Fatalities Involving Children Under the Age of Six Years (1995–2000), University of New South Wales, Injury Risk Management Research Centre, Sydney, Australia, 2002.
[32]
R. W. Byard, H. Green, R. A. James, and J. D. Gilbert, “Pathologic features of childhood pedestrian fatalities,” The American Journal of Forensic Medicine and Pathology, vol. 21, no. 2, pp. 101–106, 2000.
[33]
L. M. Olson, D. P. Sklar, L. Cobb, R. Sapien, and R. Zumwalt, “Analysis of childhood pedestrian deaths in New Mexico, 1986–1990,” Annals of Emergency Medicine, vol. 22, no. 3, pp. 512–516, 1993.
[34]
T. M. Rice, R. B. Trent, K. Bernacki, et al., “Trauma center-based surveillance of nontraffic Pedestrian injury among California children,” Western Journal of Emergency Medicine, vol. 13, no. 2, pp. 139–145, 2012.
[35]
Queensland Trauma Registry, Queensland Trauma Review: 53 Children Admitted to Hospital After Being Injured by Vehicles in Home Driveways, Centre of National Research on Disbaility and Rehabilitation Medicine, University of Queensland, 2010, http://www.uq.edu.au/conrod/docs/Feb2010-DrivewayRunOvers.pdf.
[36]
J. Hunter, H. M. Poulgrain, and M. Campbell, Accidental Child Driveway Runovers: Exploring Waikato Data and the Efficacy of Existing Responses, Summer Research Scholarship, The University of Waikato, 2009, http://researchcommons.waikato.ac.nz/bitstream/handle/10289/3700/CAPFNZ_SRS_2009.pdf?sequence=1.
[37]
K. H. Hsiao, C. Newbury, N. Bartlett, R. Dansey, P. Morreau, and J. Hamill, “Paediatric driveway run-over injuries: time to redesign?” New Zealand Medical Journal, vol. 122, no. 1298, pp. 17–24, 2009.
[38]
J. Davey, G. A. Dingle, M. J. Clark, et al., “The prevalence and characteristics of paediatric driveway accidents in Queensland,” The Journal of the Australasian College of Road Safety, vol. 18, no. 2, pp. 34–40, 2007.
[39]
Queensland Injury Surveillance Unit, Childhood Pedestrian Injury in Queensland, Queensland Injury Surveillance Unit, Brisbane, Australia, 2004, http://www.qisu.org.au/.
[40]
F. Murphy, S. White, and P. Morreau, “Driveway-related motor vehicle injuries in the paediatric population: a preventable tragedy,” New Zealand Medical Journal, vol. 115, no. 1160, article U148, 2002.
[41]
C. Di Scala, R. Sege, and G. Li, “Outcomes of pediatric pedestrian injuries by locations of event,” Annual Proceedings/Association for the Advancement of Automotive Medicine, vol. 45, pp. 241–250, 2001.
[42]
E. P. Nadler, A. P. Courcoulas, M. J. Gardner, and H. R. Ford, “Driveway injuries in children: risk factors, morbidity, and mortality,” Pediatrics, vol. 108, no. 2, pp. 326–328, 2001.
[43]
I. Roberts, R. Norton, and R. Jackson, “Driveway-related child pedestrian injuries: a case-control study,” Pediatrics, vol. 95, no. 3, pp. 405–408, 1995.
[44]
I. Roberts, A. Kolbe, and J. White, “Non-traffic child Pedestrian injuries,” Journal of Paediatrics and Child Health, vol. 29, no. 3, pp. 233–234, 1993.
[45]
M. R. Stevenson, S. K. Lo, B. A. Laing, and K. D. Jamrozik, “Childhood pedestrian injuries in the Perth metropolitan area,” Medical Journal of Australia, vol. 156, no. 4, pp. 234–238, 1992.
[46]
P. Godbole, D. C. Crabbe, and M. D. Stringer, “Four children crushed in their driveways,” Journal of the Royal Society of Medicine, vol. 94, no. 6, pp. 294–296, 2001.
[47]
T. Thinakararajan and N. Buxton, “Reversing motor vehicle injuries: a preventable tragedy,” Journal of the Royal Society of Medicine, vol. 101, no. 4, pp. 163–164, 2008.
[48]
M. S. Wright, “Nonambulatory “Pedestrians”: infants injured by motor vehicles in driveways,” Clinical Pediatrics, vol. 37, no. 8, pp. 515–518, 1998.
[49]
A. C. Duhaime, M. Eppley, S. Margulies, K. L. Heher, and S. P. Bartlett, “Crush injuries to the head in children,” Neurosurgery, vol. 37, no. 3, pp. 401–407, 1995.
[50]
M. Paine and M. Henderson, Devices to Reduce the Risk to Young Pedestrians from Reversing Motor Vehicles, Motor Accident Authority of New South Wales, Sydney, Australia, 2001.
[51]
CHOICE, “Car Rear Visibility Database: How Well Can You See out of the Back of Your Car?” 2013, http://www.choice.com.au/reviews-and-tests/travel-and-transport/cars/safety-and-advice/car-rear-visibility.aspx.
[52]
National Roads & Motorists' Association Insurance, “Reversing Visibility Results,” 2011, http://www.nrma.com.au/car-reversing-visibility-tables.
[53]
National Highway Traffic Safety Administration (NHTSA), Federal Motor Vehicle Safety Standard, Rearview Mirrors, Federal Motor Vehicle Safety Standard, Low-Speed Vehicles Phase-in Reporting Requirements, 2010, http://www.regulations.gov/#!documentDetail,D=NHTSA-2010-0162-0002.
[54]
D. S. Hurwitz, A. Pradhan, D. L. Fisher et al., “Backing collisions: a study of drivers' eye and backing behaviour using combined rear-view camera and sensor systems,” Injury Prevention, vol. 16, no. 2, pp. 79–84, 2010.
Euro NCAP, “Reward 2010—Volvo City Safety,” The European New Car Assessment Programme, 2012, http://www.euroncap.com/rewards/volvo_city_safety.aspx.
[57]
Institute of Biomedical Innovation, Take a SEC to Prevent Driveway Run-Over Tragedies, Centre for Accident Research and Road Safety—Queensland, 2012, http://www.ihbi.qut.edu.au/about/news/news-event.jsp?news-event-id=37747.
[58]
Parliamentary Travelsafe Committee, “Investigation into child deaths and injuries from low speed vehicle run-overs,” Report No. 50, Parliamentary Travelsafe Committee, Queensland Parliament, Brisbane, Australia, 2007.
[59]
Auburn City Council, Where Are Your Kids? Child Safety in Your Driveway, Auburn City Council, Auburn, Australia, 2009, http://www.auburn.nsw.gov.au/Explore/RoadSafety/RoadSafetyDocuments/Where%20Are%20Your%20Kids.pdf.
[60]
Kids and Cars, “There Are 62 Children Behind This Vehicle,” Kids and Cars, 2011, http://www.kidsandcars.org/back-overs.html#Charts.
[61]
R. E. Sapien, J. W. Roux, and L. Fullerton-Gleason, “Children's response to a commercial back-up warning device,” Injury Prevention, vol. 9, no. 1, pp. 87–88, 2003.
[62]
L. A. Petrass, J. D. Blitvich, and C. F. Finch, “Lack of caregiver supervision: a contributing factor in Australian unintentional child drowning deaths, 2000–2009,” Medical Journal of Australia, vol. 194, no. 5, pp. 228–231, 2011.
