Factors associated with the occurrence of injuries requiring hospital transfer among older and working-age pedestrians in Kurume, Japan

Background: Pedestrian injuries among older people tend to occur near their residence. However, knowledge regarding whether distance travelled from home to the injury site or road environmental/socioeconomic factors affect injury severity remains limited. Methods: A cross-sectional study was performed using injury registry data from the Kurume City Fire Department, Japan. Distance travelled from home was determined with geographic information system (GIS) software. Data were analyzed for potential association with injury occurrence and severity, with stratification by age. Signal detection analysis using 10 variables was applied to identify factors associated with the occurrence of severe pedestrian injuries. Results: Among the 545 adult pedestrian injuries reviewed, the factors associated with the occurrence of severe pedestrian injuries for older people and working-age people were evaluated, focusing on the effect of the network distance travelled from home to injury site. Network distance travelled from home to injury site was not associated with the occurrence of severe pedestrian injuries among older people. By applying signal detection analysis, for older people, higher socioeconomic status, wider road width per lane, and higher aging rate in the residential area were significant factors, and for working-age pedestrians, longer network distance travelled between injury place and their residential area and a higher aging rate in the residential area were significantly associated. Conclusions: To reduce severe pedestrian injuries among older people, improvement of road infrastructure in areas with wider roads, higher socioeconomic status and higher aging rates is required.