• Yuxi Liu, Meixian Wang, Leni Kang, Chunhua He, Lei Miao, Lingxiao Chen, Siyan Zhong, Jun Zhu, Juan Liang, Qi Li, Yanping Wang, and Hanmin Liu.
• National Office for Maternal and Child Health Surveillance of China.
• Medicine (Baltimore). 2020 Apr 1; 99 (17): e19825.

BackgroundRoad traffic injuries (RTIs) have become a considerable issue for children. In China, RTIs are among the top 3 contributors to injury-related mortality and disability-adjusted life years. The present study aimed to evaluate social and environmental factors that may contribute to RTIs among children under 5 in rural areas of China.MethodsThe study was based on 1 year of data (October 1, 2015 to September 30, 2016) from the National Maternal and Child Health Surveillance System (NMCHSS) from all districts in 334 National Maternal and Child Health Surveillance Districts in 30 Chinese provinces, autonomous regions, and municipalities. Data were analyzed to identify environmental, social, and primary caregiver factors related to RTIs among children under 5.ResultsBased on data for the 279 children registered in the NMCHSS during the study period, incidence of RTIs increased with increasing age and was higher for boys than girls. Risk of RTIs depended on distances from the child's home to roads and playgrounds. Enrollment in kindergarten and characteristics of primary caregivers affected risky road behaviors by children. Most primary caregivers (67.4%) reported never using child car seats, and 70.6% reported never using a child helmet. Among primary caregivers without a driver's license, 24.8% reported having driven motor vehicles or motorcycles.ConclusionsThe living environment and behaviors of primary caregivers can affect risk of RTIs in children younger than 5 years in rural China. Road safety awareness should be strengthened at the community and kindergarten levels.

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