Childhood Pedestrian Deaths During Halloween -- United States, 1975-1996

During 1995, pedestrian deaths accounted for approximately 15% of all motor-vehicle-related deaths sustained by children aged 0-19 years in the United States (1). Because of the levels of participation in Halloween-related activities by elementary and middle school-aged children, these children might be more likely to sustain pedestrian injuries on that evening than on other evenings. To characterize the occurrence of fatal pedestrian injury among children on Halloween, CDC analyzed mortality data from the Fatal Analysis Reporting System (FARS) of the National Highway Traffic Safety Administration (NHTSA) during 1975-1996. This report summarizes the results of the analysis and suggests measures to prevent Halloween-related pedestrian injuries and deaths among children. The findings indicate that the number of childhood pedestrian deaths increased fourfold among children on Halloween evenings when compared with all other evenings.

FARS is a record of all motor-vehicle crashes that occur on public roads in the United States and result in the death of an occupant or nonmotorist within 30 days. NHTSA compiles data from police crash reports, death certificates, coroner reports, hospital records, emergency medical system reports, state highway department information, and other sources. For this analysis, Halloween-related pedestrian deaths were defined as deaths resulting from motor-vehicle crashes on October 31 each year from 4 p.m. through 10 p.m. This time period was selected because most outdoor Halloween activities among persons aged 5-14 years occur during these hours.

During 1975-1996, from 4 p.m. through 10 p.m. on October 31, a total of 89 deaths occurred among pedestrians aged 5-14 years, compared with 8846 on all other evenings. Overall, among children aged 5-14 years, an average of four deaths occurred on Halloween during these hours each year, compared with an average of one death during these hours on every other day of the year.

Reported by: Div of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: The findings in this report indicate that, during 1975-1996, the number of deaths among young pedestrians was fourfold higher on Halloween evening when compared with the same time period during all other evenings of the year. This analysis may undercount the number of deaths because 1) FARS does not include off-road motor-vehicle crashes (e.g., crashes that occur in driveways, parking lots, and on sidewalks); 2) Halloween activities occasionally occur on another day, particularly if October 31 is a Sunday; and 3) some Halloween activities extend beyond 10 p.m.

Child pedestrian injuries result from an interrelated set of factors involving the driver, the child, and their surroundings. Halloween poses special environmental and behavioral risks compounded by the inherent limitations of the child's developmental stage. Most of the time children spend outdoors is during daylight hours; however, Halloween-related activities occur primarily after dark. This period of darkness is lengthened by the return to Standard Time, which immediately precedes Halloween. In addition, children engaged in door-to-door "trick or treat" activities frequently cross streets at midblock rather than at corners or crosswalks, a known risk factor for pedestrian collision (2). Black costumes can further limit the visibility of young pedestrians to drivers. Sensory acuity may be decreased by masks that can restrict peripheral vision and hearing. Attention to sensory input may be decreased because of distractions, including urges to acquire the best candy, shouts from other children, eye-catching costumes and decorations, and time pressure to acquire candy.

In addition to these holiday-specific problems, the pedestrian skills of children are limited by at least five factors related to their physical attributes (e.g., size and motor coordination) and developmental stage that impair their street-crossing skills until approximately age 12 years (3). First, young children may lack the physical ability to rapidly cross the street, and their short stature limits their visibility to drivers. Second, children are likely to choose the shortest rather than safest route across streets, often darting out at mid-block or entering the roadway between parked cars (4). Third, children normally disregard peripheral vision, have reduced attentiveness, localize sounds poorly, and lack sufficient impulse control (5). Fourth, young children do not evaluate potential traffic threats effectively; they cannot anticipate driver behavior, have less acute sensory perception, and process sensory information more slowly than adults (3,6). Fifth, children may engage in "magical thinking" that leads them to believe, for example, that they are protected from vehicular harm within the confines of a painted crosswalk (6,7).

Parents and caregivers of young children may overestimate the ability of their children to negotiate traffic independently (8), underscoring the need for constant adult supervision of school-aged children during trick-or-treat activities. Public health departments and schools should emphasize the importance of adult supervision and other injury-prevention measures just before Halloween (see box) (Table_1B).

References

1. NCHS. Vital statistics mortality data, underlying cause of death, 1995 {Machine-readable public-use data tapes}. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, NCHS, 1997.

2. Snyder MB, Knoblauch RL. Pedestrian safety: the identification of precipitating factors and possible countermeasures. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1971; publication no. DOT-HS-800-403.

3. Schieber RA, Thompson NJ. Developmental risk factors for childhood pedestrian injuries. Injury Prevention 1996;2:228-36.

4. Chapman AJ, Wade FM, Foot HC. Pedestrian accidents. Chichester, United Kingdom: John Wiley and Sons, 1982.

5. Wilson MH, Baker SP, Teret SP, Shock S, Garbarino J. Saving children, a guide to injury prevention. New York: Oxford University Press, 1991.

6. Piaget J. The child's concept of movement and speed. London: Routledge and Kegan Paul, 1970.

7. Pease K, Preston B. Road safety education for young children. Br J Educ Psychol 1967;37:305-13.

8. Dunne RG, Asher KN, Rivara FP. Behavioral and parental expectations of child pedestrians. Pediatrics 1992;89:486-90.

Safety Tips for Halloween
Pedestrian Safety
-- Parents should establish a route for children in a known
   neighborhood.
-- Children should use flashlights, stay on sidewalks, and avoid
   crossing yards.
-- Children should cross streets at the corner (using crosswalks
   when they exist) and not between parked cars.
-- Children should stop at all corners and stay together in a group
   before crossing.
-- Motorists should drive slowly, watch for children in the street
   and on medians, and exit driveways and alleyways carefully.
-- Children should wear clothing that is bright, reflective, and
   flame retardant.
-- Children should consider using face paint instead of masks, or
   should wear masks that are well-fitting with eye- and ear-holes
   that do not obscure sight or hearing; children should not wear
   floppy hats or hats that will slide over the eyes.
-- To reduce the likelihood of tripping, children should not wear
   long, baggy, or loose costumes or oversized shoes.
   General Safety Planning
-- Parents should establish a curfew for older youth.
-- Children should only go to well-lit houses and remain on porches
   rather than entering houses.
-- Children should travel in small groups and should be accompanied
   by an adult.
-- Children should know their phone number and carry coins for
   emergency telephone calls.
-- Children should have their names and addresses attached to their
   costumes.
-- Children should bring treats home before eating them so parents
   can inspect them.
-- Adults should prepare homes for trick-or-treaters by clearing
   porches, lawns, and sidewalks and by placing jack-o-lanterns away
   from doorways or landings.
-- Children should use costume knives and swords that are flexible,
   not rigid or sharp.
-- Adults and children who are carving pumpkins should use stable,
   flat surfaces with good lighting; draw and follow patterns on the
   outside of the pumpkin instead of freehand carving; and use blunt
   instruments with dull serrations specially designed for pumpkin
   carving.

Sources: U.S. Consumer Product Safety Commission and the National
SAFE KIDS Campaign.

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