Objective: Pedestrians are vulnerable road users who are at risk of injuries and death on the roads. We aimed to define factors affecting pedestrian injuries-related deaths worldwide and to give recommendations regarding their prevention priorities. Methods: Data on pedestrian injuries-related deaths for years 2007 and 2010 were retrieved from the WHO global status reports on road safety. These included the country population, gross national income (GNI), number of registered vehicles, estimated pedestrian deaths rate, effectiveness of enforcement of law, and the presence of policies to promote walking or cycling. Correlations between studied variables were done using Spearman rank correlation. General linear models were used to define factors affecting pedestrian injuries-related deaths. Results: The median (range) pedestrian death rates of different countries per 100,000 population significantly decreased in year 2010 compared with year 2007 [3.9 (0-13.5) compared with 4.2 (0-23.6), (p = 0.004, Wilcoxon signed rank test)]. There was a reduction of 8.1 % of the global pedestrian death rate between 2007 and 2010. The estimated pedestrian lives saved annually worldwide of a population of 6.8 billion were 23,120 persons. A general linear model has shown that GNI (p = 0.001) and population density (p = 0.01) were the best predictors of pedestrian death rates in 2007, while national legislation (p = 0.03) was the best predictor of pedestrian death rates in 2010. Conclusions: There is a change in the factors affecting pedestrian mortality worldwide over time. GNI and population density became less significant than national legislation enforcement. Legislation and its enforcement are important to achieve the UN mission of reducing road traffic deaths by 5 million over the next decade.
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