Characteristics of back-over injuries among young children: A study from eight California trauma centers

Background

Every year in the US, hundreds of children are killed or injured by vehicles in driveways or parking areas. These are often young children who are playing at or near their home; the drivers are often family members. Little is known about the risk factors for these events and incidence is difficult to estimate because case ascertainment using police collision reports is incomplete.

Methods

Eight California trauma centers conducted surveillance of pediatric back-over and front-over injury from January 2005 to July 2007. Identified patients and families at each facility were invited to participate in an interview to identify circumstances of the incident.

Results

A total of 93 incidents were identified. Nine (10%) were fatal. Sixty-nine (74%) of the patients were four years old or younger. Twenty-one (23%) families agreed to participate in an interview.

Of the 21 victims whose families were interviewed, 17 (81%) were male and the median age was 28 months. In 13 (62%) cases, the child was backed over, and in 11 (52%) cases, the driver was the mother or father. Fifteen (71%) cases involved a sports utility vehicle, pick-up truck, or van. Most of these incidents occurred in a residential driveway. Average length of stay in the hospital was 2.9 days.

Conclusion

Surveillance of back-over injury using police and EMS data is needed to enhance our understanding of this problem and to inform prevention efforts. Case-control studies of risk factors are needed to clarify causal factors and to identify modifiable risk factors.