Background Distracted walking is a major risk factor for pedestrian injury, but it is unknown whether pedestrians have different risks of distracted walking in some road environments compared to others.

Methods An observational study was conducted at 20 intersections in Changsha, China. We developed a composite measure distracted behavior (called the ‘distraction index’) based on types and duration of pedestrian distraction. Another composite indicator, ‘road environmental risk score’, was constructed on the basis of eight variables on road environment and traffic volumes. The mediating effect of distraction index was examined while studying the impact of road environmental risk score on the risk of near-crash events.

Results In total, 8729 of 25436 (38.9%) pedestrians were distracted by mobile phone use, interaction with others, or eating/drinking/smoking while walking. A higher distraction index was related to higher risk of near-crash event (p<0.05). The distracted index was positively associated with the road environmental risk score (p<0.05). Pedestrians with high and medium road environmental risk scores had higher risks of a near-crash event than those with low scores (RR=1.41, 95% CI: 1.15, 1.73; RR=1.56, 95% CI: 1.28, 1.92). Road environment yielded an indirect effect on near-crash event; the effect was mediated by the distracted walking index, accounting for 5.3% of total variance.

Conclusion Specific road traffic environments raise the severity of distracted walking, which further threatens pedestrian safety.

Learning Outcomes Specific road environmental risk increases the severity of distracted walking, additionally creating an indirect impact on near-crash event.