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The association of road safety knowledge and risk behaviour with paediatric road traffic injury in Guangzhou, China
  1. Xiaomei Dong1,2,
  2. Corinne Peek-Asa3,4,
  3. Jingzhen Yang3,5,
  4. Shengyong Wang1,2,
  5. Xiongfei Chen6,
  6. Guibo Chi1,2,
  7. Marizen Ramirez3,4
  1. 1Center for Injury Prevention and Control, Medical College of Jinan University, Guangzhou, Guangdong, China
  2. 2Department of Epidemiology, Medical College of Jinan University, Guangzhou, Guangdong, China
  3. 3Injury Prevention Research Center, The University of Iowa, Iowa City, Iowa, USA
  4. 4Department of Occupational and Environmental Health, The University of Iowa, Iowa City, Iowa, USA
  5. 5Department of Community and Behavioural Health, The University of Iowa, Iowa City, Iowa, USA
  6. 6Guangzhou Center for Disease Control and Prevention, Guangzhou City, Guangdong, China, USA
  1. Correspondence to Dr Corinne Peek-Asa, University of Iowa, 100 Oakdale Campus, 114 IREH, Iowa City IA 52242, Iowa, USA; corinne-peek-asa{at}


Background This study describes road traffic injuries among school-aged children in Guangzhou, China, and examines the effect of road safety knowledge and risk behaviours on road traffic injuries.

Methods A stratified cluster sample of 3747 children from six primary schools and six middle schools in Guangzhou, China, was surveyed. Data were collected on sociodemographic factors and road traffic injuries during the past year. Knowledge about road safety rules was assessed using a 14-item road safety knowledge index, and risky road safety behaviours were measured using a 25-item road safety behaviour index.

Results A total of 403 (10.8%) students reported having at least one road traffic injury during the past 12 months. A high proportion of injuries was found among children who were boys, in primary school and from the suburbs. Bicycle-related injuries were the most common (46.0% of all injuries). Motor vehicle-related injuries had higher hospitalisation rates and worse psychological impact than bicycle or pedestrian injuries. Children with low and medium road safety knowledge had 1.5 to 3 times the odds of injury compared with students with high road safety knowledge. Students with high scores on the risky road behaviour index had twice the odds of injury (OR 2.04, 95% CI 1.47 to 2.84) compared with students with low scores.

Conclusion Better road safety knowledge and the avoidance of walking or cycling-related risk behaviours are protective factors for road traffic injuries among Chinese school children. More injury prevention programmes are needed to improve road safety knowledge and reduce risk behaviours.

  • Bicycle
  • child
  • China
  • international
  • knowledge
  • MVTC
  • pedestrian
  • risk behaviour
  • road traffic injuries
  • school children
  • students

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  • Funding Funding for research support by the Emergency Management Office, the People's Government of Guangdong Province (Study on the Technology Support System of Emergency Management), Health Department of Guangdong Province (Study on the Practice of Regional Medical Rescue Center) and the 211 major projects of Jinan University (Study on the Theory and Practice of Emergency Management). Additional funding was provided by the US CDC/NCIPC funded University of Iowa Injury Prevention Research Center (CDC CCR 703640) and the NIH-Fogarty funded University of Iowa Trauma Training Program (5D43TW007261).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Medical College of Jinan University.

  • Provenance and peer review Not commissioned; externally peer reviewed.