Factors affecting the severity of pedestrian traffic crashes

Background: Considering the importance of pedestrian traffic crashes and the role of environmental and demographic factors in the severity of these crashes, this article aimed to review the published evidence and synthesize the results of related studies to determine any associations between demographic and environmental factors and the severity of pedestrian-vehicle crashes. Methods: All epidemiological studies published from 1970 to 2019 were searched in international electronic databases (PubMed [Medline], Scopus, Web of Science, Embase, ScienceDirect, and Ovid) and reference lists of the identified articles were also searched. Studies were included if they investigated the severity of pedestrian-vehicle crashes as outcome, measured any environmental and demographic factors for pedestrian-vehicular crashes as exposure, designed observational, and if they were written in all languages. Quality of included studies was evaluated using the strengthening the reporting of observational studies in epidemiology checklist for observational studies. Results: We found 3126 references among which 24 studies were included in this review. All retrieved studies were conducted between 1990 and 2019 and had a cross-sectional design. In most of these studies, the associations between environmental and demographic variables such as vehicle speed or speed limits, pedestrian age, lighting, type of road, type of vehicle, and alcohol intake with the severity of pedestrian traffic crashes were examined. Conclusion: This study showed that few studies were conducted in this area; in fact, most of the studies were carried out in metropolises of developed countries. As a result, studies which provide strong causal inferences by focusing on high-risk groups and a higher level of evidence such as cohort and case-control ones are needed in developing countries.