An investigation of the built environment risk factors related to specific mechanisms of injury between children and adolescents in three Canadian Cities.
Author(s): Aucoin, Hou, HubkaRao, Pitt, Zanotto, Ling, Doan, Beno, Stang, Howard, McCormack, Nettel-Aguirre, Teschke, Winters, Hagel
Slidedeck Presentation:
Abstract:
Background:
Bicycling improves the health of children along with increasing physical literacy; yet, in Canada, there is an ongoing decline in bicycle participation in part due to the perceived risk of injury. Bicycling injuries are one of the leading causes of sport and recreation related ED visits, hospitalizations, and deaths for children in Canada. Circumstances associated with children’s bicycling injuries are unique when compared with adults. Among children, different age groups (5-12 versus 13-17 years old) may also demonstrate differences in injury mechanisms. Despite being imperative for the development of primary prevention strategies, there remains a lack of knowledge related to the mechanisms of bicycling injuries and built environment role in children compared with adolescents.
Aims:
To compare the mechanism of injury (falls versus collisions) and built environment injury risk factors between children (5-12 years old) and adolescents (13-17 years old) in three urban centres across Canada.
Methods:
Youth aged 5-17 years injured while riding their bicycle within city limits and who presented to the designated children's hospital within one of the three municipalities (Vancouver, Calgary, and Toronto) from May 2018 to December 2020 were recruited for participation. Participants completed a 30-minute interviewer-administered questionnaire that captured the mechanisms and circumstances of injury from the perspective of the child bicyclist. Following the interview, the research team conducted audits of the injury site to capture objective data on the built environment. Descriptive statistics will be calculated to summarize the distribution of mechanism of injury (falls versus collisions), type of collision, intersection presence, grade, road type, debris, surface condition and land use, stratified by age group.
Results:
To date, 257 participant interviews have been completed (Vancouver – 95, Calgary – 70, Toronto – 92). Preliminary findings suggest that a larger proportion of children (<13 years old) have cited a fall as their mechanism of injury compared with collision. Findings suggest that a higher proportion of children fell on a flat surface and fell in areas with no debris compared with adolescents. Adolescents (? 13 years old) reported a larger proportion of collisions compared to falls and are more frequently injured on non-local streets, areas with gravel, and/or in commercial areas than children.
Discussion:
Preliminary findings suggest that mechanisms of injury and built environment risk factors for child bicyclists differ from adolescents. Next steps include completing analysis and expanding upon mechanism of injury to include additional details about circumstances. Additional analysis to explore different age groupings/cut-offs will be completed. By better understanding the different mechanisms of injury and built environment risk factors for children and adolescents, we can inform key stakeholders at municipal, provincial, and federal levels as they develop policy and education interventions to increase child and adolescent bicyclist safety and participation.
Conclusions:
Additional information on youth bicyclist injuries from this study can inform the development of primary prevention interventions. By carefully examining the mechanisms and built environment risk factors for child and adolescent bicyclist injuries we will improve the evidence base for recommendations to create safer built environments for youth while encouraging bicycling across Canada.