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Risk of Pediatric Back-over Injuries in Residential Driveways by Vehicle Type

Pinkney, Kerrie A. MD, MPH*; Smith, Andrew MD; Mann, N. Clay PhD, MS; Mower, Gary D. BS; Davis, Anna RN, MPH; Dean, J. Michael MD, MBA

doi: 10.1097/01.pec.0000221337.29551.00
Original Articles

Objective: Research suggests that children experience driveway back-over injuries at a significant rate and the severity of the resulting injuries differ by type of vehicle. Yet, no US study attempted to quantify "back-over risk" for classes of vehicles because of the difficulties with determining exposure. Using vehicle registration information, we set out to estimate the relative risk of driveway back-over injuries to children by type of vehicle.

Methods: Driveway back-over events were identified from state police reports and medical records from the state level 1 pediatric trauma center and compared with vehicle registration information to estimate injury incidence for 4 classes of vehicles (passenger cars, trucks, sport utility vehicles, and minivans) over 6 years in the state of Utah.

Results: Reported driveway back-over injuries represent an incidence of 7.09 per 100,000 children (<10 years old) per year. Overall, passenger cars account for 1.62 injuries per 100,000 registered vehicles. Compared with passenger cars, children were 53% more likely to be injured by a truck (P = 0.01) and 2.4 times more likely to be injured by a minivan (P < 0.001). Among children transported to a trauma center, admission (P = 0.01) and need for surgery (P = 0.03) were greater among children backed over by trucks, sport utility vehicles, and minivans compared with passenger cars.

Conclusions: Findings suggest that when assessing driveway back-over injuries, larger high-profile vehicles are associated with a higher incidence and severity of injuries when compared with injuries resulting from passenger cars.

*Children's Hospital of Philadelphia, Philadelphia, PA and Lehigh Valley Hospital, Allentown, PA; †University of Utah, School of Medicine, Salt Lake City, UT and Intermountain Injury Control Research Center; ‡Utah Department of Health, Salt Lake City, UT and Violence and Injury Prevention Program.

Presented at the Third National Congress on Childhood Emergencies, April 2002, Dallas, TX.

Address correspondence and reprint requests to Kerrie A. Pinkney, MD, MPH, FAAP, Children's Hospital of Philadelphia, Staff Intensivist, Children's Critical Care Center, 6th Floor, Jaindl, Lehigh Valley Hospital, Box 689, Cedar Crest and I-78 Allentown, PA 18105-1556. E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.