Comparison of Risk Factors for Pedestrian Fatality in Urban and Suburban Traffic Accidents

Document Type: Original Article


1 Instructor, Msc of Epidemiology, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran

2 Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran,

3 Department of Social Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran

4 Legal Medicine Research Center, Legal Medicine Organization, Iran

5 Department of Epidemiology, Safety Promotion and Injury Prevention Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: The burden of traffic accidents on pedestrians is very high in Iran. Since the pattern of injury is different in urban and suburban
accidents, this study was conducted to identify the risk factors associated with pedestrian mortality in urban and suburban traffic accidents in
Tehran and Alborz Provinces. Materials and Methods: The data of all traffic accidents related to pedestrians in Tehran and Alborz Provinces
were investigated from two databases of traffic police and forensic medicine. The effects of demographic variables (age and gender) and
pedestrian position, time, accident location, and vehicle type on the outcome of pedestrian death were investigated. Multiple logistic regression
was used to analyze the data. The significance level was considered Results: From a total of 10742 pedestrians, 6804 males (63.3%) and 3938 females (36.7%) were studied in traffic accidents. In urban accidents,
the effects of pedestrian age such as 35–64 years and >65 years compared to 15–24 years (odds ratio [OR]: 2.04, confidence interval [CI]:
1.26–3.3), (OR: 4.8, CI: 2.9–7.9), male gender (OR: 2.26, CI: 1.6–3.1), lighting condition at night compared to day (OR: 1.6, CI: 1.2–2.1),
two‑way not divided road versus one‑way road (OR: 1.6, CI: 1.12–2.3), the status of day after holidays compared to normal days (OR: 1.53,
CI: 1.09–2.14), type of vehicle such as heavy or semi‑heavy and conventional or pickup versus motorcycles or bicycles (OR: 5.4, CI: 3.1–8.9)
and (OR: 1.8, CI: 1.2–2.7) and pedestrian position at crossing the road from an unauthorized route compared to crossing the road from the
authorized route (OR: 1.94, CI: 1.4–2.6) were significant on the fatality. Whereas in suburban accidents, there was a statistically significant
correlation with pedestrian fatality only in two‑way divided road compared to one‑way (OR: 0.2, CI: 0.05–0.77). Conclusion: The present
study showed that risk factors for pedestrian mortality are different in urban and suburban traffic accidents. It is necessary to take appropriate
measures in urban and suburban areas to reduce the severity of injuries in pedestrians.


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