Child road traffic injury mortality in Victoria, Australia (0-14 years), the need for targeted action

Abstract

Introduction: Extensive efforts to reduce unintentional injury were enacted in the last three decades of the 20th century. Examination of road traffic injury mortality indicates the extent of fatal, unintentional child injuries (0-14 years) future interventions must address.

Aims: (1) describe in-depth child road traffic injury (RTI) deaths 2001-2012 in Victoria, Australia (2) identify the potential preventability of the RTI causes by currently available countermeasures and scope for enhanced implementation and novel solutions.

Method: Fatal Victorian child injury data were extracted from the National Coronial Information System (NCIS) for the 12 year period January 2001-December 2012. All on-road data was analysed. Data for passenger and pedestrian deaths was examined in depth. Associated factors were determined using univariate and pairwise analysis of factors. Published WHO key prevention strategies, and the recent literature were reviewed, focusing on the identified fatalities among children 0-14 years.

Results: For 172 RTI deaths, head injury was the leading medical cause of death (68%). Significantly, the most vulnerable age group for both passengers and pedestrians was 0-4 years. Rural children were over-represented with children aged 0-4 years at greatest risk. Common factors for occupants were loss of control and veering to the incorrect side. For pedestrians the major factors related to rural residence and supervision.

Discussion and conclusions: This study confirms that RTIs are complex and follow chains of events. Numerous promising interventions were identified. Wider implementation of these advanced engineering, education and enforcement strategies may further improve mortality rates in Victoria. Feasible solutions for aspects of the child pedestrian problem remain elusive. This study describes the RTI problem in greater depth than previous studies and reveals that some existing measures are not fully implemented. The need for targeted action in: 0-4 year olds; head injury; and rural regions of Victoria is highlighted. The need for a safe systems approach is paramount.

Keywords: 0–14 years; Children; High income countries (HIC); Road traffic injury (RTI).