Differences between Japanese pre-school and school-age pedestrian mortality and morbidity trends.

The risk of pedestrian injury during childhood in industrialised countries is decreasing in a trend that is related to exposure to traffic. Examining the differences between age groups and their behaviour provides an insight into exposure to risks. Using data for the period 1968-1998, we compared the changes in pedestrian mortality and morbidity in pre-school children (aged 0-6) with those of school-age children (aged 7-12). Pedestrian mortality and morbidity decreased in children of all ages in the early 1970s. However, after the mid-1970s, both mortality and morbidity continued to decrease only in pre-schoolers. In school-age children, mortality continued to decrease but morbidity did not change. These age-related differences in mortality and morbidity indicate that over the past 30 y the environment for child pedestrians did not become safer. Instead, some of the decrease in children's injuries was probably achieved at the expense of their outdoor activities. Efforts to protect children from vehicular traffic should focus on changing the outdoor environment rather than on restricting children's activities.