The CMAJ review on child injuries and the built environment by Andrew Howard 1 is a valuable contribution to the literature. However, the review ignores developing countries, where more fatal child pedestrian injuries occur on a daily basis than in most industrialized countries. Research shows that economic factors may play a role in the higher incidence of child pedestrian crashes in developing countries, because many of the children injured were engaged in buying and selling goods along the roadsides. 2 We also need to recognize that, apart from other pedestrian-related risk factors, vulnerable children in underdeveloped countries are victims of poor design features of vehicles. These vehicles are made in and for industrialized countries, and do not take the unique traffic situations in developing countries into consideration. Now is the time to incorporate effective technology and materials that could reduce the impact of motor vehicle crashes on child, and all, pedestrians.
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For the full letter, go to: www.cmaj.ca/cgi/eletters/cmaj.080162v1#216262