摘要：Objectives . We evaluated the protective effectiveness of speed humps in reducing child pedestrian injuries in residential neighborhoods. Methods . We conducted a matched case–control study over a 5-year period among children seen in a pediatric emergency department after being struck by an automobile. Results . A multivariate conditional logistic regression analysis showed that speed humps were associated with lower odds of children being injured within their neighborhood (adjusted odds ratio [OR] = 0.47) and being struck in front of their home (adjusted OR = 0.40). Ethnicity (but not socioeconomic status) was independently associated with child pedestrian injuries and was adjusted for in the regression model. Conclusions . Our findings suggest that speed humps make children’s living environments safer. Pedestrian injuries caused by automobile collisions are a leading cause of death among children aged 5 to 14 years. 1 The demographic characteristics of children injured by automobiles have remained the same over the past 20 years, with boys, children between the ages of 5 and 9 years, and children living in neighborhoods of low socioeconomic status (SES) at highest risk. 2– 4 Children en route to school or at play in front of their homes are exposed to roads and street traffic. Modifying traffic patterns is a passive and sustainable public health intervention that may make children’s living environments safer. 5 Traffic patterns can be modified with a number of engineering strategies that fall under the rubric of “traffic calming.” Distinct from speed limit signs or stop signs, traffic calming measures such as speed humps, street closures, median barriers, and traffic circles are successful in providing long-term safety for pedestrians and motorists because they are physical structures with designs that are self-enforcing rather than requiring police enforcement. 6– 8 For years, European countries such as Denmark, the Netherlands, and Great Britain, as well as Australia and New Zealand, have implemented and tested the effects of traffic calming. 6 A report published in British Columbia summarized 43 international studies that demonstrated reductions in collision frequency rates ranging from 8% to 100% after implementation of traffic calming measures. 6 A Danish study showed that, in comparison with control streets, 72% fewer injuries occurred on experimental streets incorporating a variety of traffic calming measures in addition to new speed zoning requirements. 9 As a result of the successful efforts in other countries, there is developing interest in traffic calming in the United States, and the Federal Highway Administration, in cooperation with the Institute of Transportation Engineers, has initiated a national traffic calming technical assistance project. 6 However, the majority of safety studies focusing on traffic calming measures have assessed accident statistics before and after installation, and there is no available hospital-based information on the specific effects of these interventions on childhood pedestrian injury. Oakland has historically been one of the most dangerous cities in California in which to be a pedestrian, exhibiting, for example, the highest rate of pedestrian fatalities among the state’s cities in 1995. 10 In that year, after a series of child pedestrian deaths, the Oakland Pedestrian Safety Project was formed. This multidisciplinary alliance addressed child and senior pedestrian injuries occurring in the city of Oakland and advocated for installation of speed humps. Over the 5-year period 1995 to 2000, Oakland installed about 1600 speed humps on residential streets. In this study, we examined the effect of residing on a street with speed humps on the odds of child pedestrian injuries in Oakland.
