The walking environment in Lima, Peru and pedestrian-motor vehicle collisions: An exploratory analysis

ABSTRACT<b>Objective:</b> Pedestrians comprise 78% of the road fatalities in Peru. The objective of this study was to explore the relationship between the walking environment and pedestrian-motor vehicle collisions.<b>Methods:</b> A matched case-control study was used to detect the odds of a pedestrian-motor vehicle collision at a pedestrian crossing location. Data were collected within eleven sampled police commissaries in Lima, Peru.<b>Results:</b> In a multivariable model adjusting for vehicle and pedestrian flow, pedestrian collisions were less likely in the presence of a curb and sidewalk on both roadway sides (Odds Ratio [OR] 0.19, 95% Confidence Interval [CI] 0.11-0.33) or a pedestrian barricade (OR 0.11, 95% CI 0.01-0.81). There was a greater risk of collisions for each street vendor present (OR 2.82, 95% CI 1.59-5.00) or if any parked vehicles (OR 3.67, 95% CI 1.18-11.4) were present.<b>Conclusions:</b> Improving or addressing these potentially modifiable features of the walking environment could improve pedestrian safety in Lima and in similar urban settings in low and middle-income countries.