The “Unintended Pedestrian” on Expressways

Abstract

Objective. To explore the epidemiology of pedestrian deaths in Dallas County, Texas, and to compare factors associated with pedestrian deaths on expressways versus those that occurred on other roadways.

Methods. We studied all pedestrian deaths among persons 15 years of age or older in Dallas County, Texas, from 1997 to 2004 by linking data from Medical Examiner's office, the Fatality Analysis Reporting System, and local police records. Univariate and multivariate analysis compared various factors associated with death on an expressway.

Results. Among 437 pedestrian deaths who were 15 years of age or older, 197 (45%) occurred on expressways; the proportion that occurred on expressways was highest among 15- to 29-year-olds (65%) and was lower with advancing age group (p < 0.01, chi square for trend). At least 36% of these expressway-related pedestrian deaths were known to have been “unintended pedestrians,” who had exited a vehicle after being on the roadway, compared with 11% of pedestrian deaths on surface streets (OR 4.6, 95% CI, 2.7–8.1), and this was also highest among younger age groups. Pedestrian deaths on an expressway, compared with deaths on surface streets, remained strongly associated with having been an “unintended pedestrian” (OR 6.2, 95% CI, 3.1–14.0), after controlling for several other variables, including age, sex, race, nighttime of crash, and alcohol involvement.

Conclusions. Expressways are the predominant site of fatal pedestrian crashes among young adults in this urban area. Since many of these deaths were “unintended pedestrians,” procedures for management of occupants of disabled vehicles on expressways could have a large impact on pedestrian deaths in young adults.

Keywords:

• Injury
• Pedestrian
• Unintended
• Expressway
• Freeway
• Trauma
• Epidemiology
• Prevention

ACKNOWLEDGMENTS

We are indebted to the staff of the Dallas County Medical Examiner office for their assistance in collecting data and to the staff of the Dallas branch of the Texas Department of Public Safety for assistance in obtaining traffic investigation records.

This work was supported, in part, by contract number 585XXF8007 from the Texas Department of Transportation, which had neither a role in any aspect of the study nor in any review or approval of the manuscript.

Presented, in part, to the American Public Health Association Annual Meeting, San Francisco, November 2003, and to the Injury and Violence in America Conference, Denver, May 2005.

Notes

¹Expressway = limited-access highway.

²Unintended pedestrian = person who entered roadway in a motor vehicle, then exited the vehicle and was killed as a pedestrian.

³ p < 0.001 by chi square for trend, by age group.