2022, Vol. 43
文章信息
- 宁佩珊, 胡国清.
- Ning Peishan, Hu Guoqing
- 行人分心流行特征与干预研究进展
- Progress on epidemiological characteristics and interventions of pedestrian distraction
- 中华流行病学杂志, 2022, 43(2): 277-281
- Chinese Journal of Epidemiology, 2022, 43(2): 277-281
- http://dx.doi.org/10.3760/cma.j.cn112338-20210629-00503
-
文章历史
收稿日期: 2021-06-29
引用本文
宁佩珊, 胡国清. 行人分心流行特征与干预研究进展[J]. 中华流行病学杂志, 2022, 43(2): 277-281 
Ning Peishan, Hu Guoqing. Progress on epidemiological characteristics and interventions of pedestrian distraction[J]. Chinese Journal of Epidemiology, 2022, 43(2): 277-281.
行人分心流行特征与干预研究进展
中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410078
摘要: 行人分心是交通伤害的重要危险因素之一。本文就国内外行人分心流行特征、影响因素、安全影响，以及现有干预措施进行综述。结果显示：①行人分心发生率高，严重威胁行人安全，但当前大多数行人分心流行特征研究集中于手机使用，采用不同研究方法、来自不同国家的行人分心发生率存在较大差异；②人口学特征、社会心理和环境是行人分心发生的主要影响因素；③行人分心通过对生理认知、运动控制、过街效率和过街行为造成不同程度的影响，威胁行人安全；④工程干预和教育是最常见的行人分心干预措施，但大多数措施的效果未被严格评估。建议未来从多学科角度开展深入的流行病学研究，精准设计干预措施，严格评估干预措施的效果，为减少行人分心、提高行人交通安全提供科学依据。
关键词:
行人分心 交通安全 流行现状 影响因素 干预措施
Progress on epidemiological characteristics and interventions of pedestrian distraction
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
Abstract: Pedestrian distraction is one of the important risk factors of road injury. This review summarized the epidemiological characteristics, influencing factors, safety implications, and the published intervention measures. The review found that: a) the prevalence of pedestrian distraction poses a serious threat to pedestrian safety, but most epidemiological studies on pedestrian distraction focus on mobile phone use, and the incidence of pedestrian distraction varied greatly across studies using various research methods and from different countries; b) demographic characteristics, social psychology, and environment are the three main influencing factors of pedestrian distraction; c) distraction differently affected physiology, cognition, motion control, efficiency and behavior of pedestrian's street-crossing to some degrees, threatening the safety of pedestrian; d) engineering interventions and education were the most common interventions to prevent pedestrian distraction currently, but the effectiveness of most measures was not assessed rigorously. In the future, multidisciplinary and systematic epidemiological studies are recommended to design interventions purposely and evaluate the effectiveness of interventions through rigorous designs, providing scientific evidence for reducing pedestrian distraction and improving road safety of pedestrians.
Key words:
Pedestrian distraction Road safety Epidemiological situation Influencing factor Intervention measure
近年来，随着全球信息化和机动化水平的快速提升[1-2]，行人分心发生风险日益增加，严重威胁行人安全。2017年澳大利亚昆士兰州的一项调查结果显示，行人过街时使用手机的发生率达20.0%[3]。过街时听音乐和发短信行人发生交通事故的风险分别是未分心行人的7.9倍和5.3倍[4]。
本文系统梳理全球2005年1月至2021年5月发表在美国生物医学信息检索系统（PubMed）、Web of Science、中国知网、万方数据知识服务平台的行人分心流行特征与干预措施研究文献，为国内学者开展进一步研究和管理部门制定针对性干预措施提供参考。
1. 行人分心流行现状：本研究共纳入18篇行人分心发生率文献[3, 5-21]。总体而言，12篇文献针对手机使用分心，另有6篇文献研究其他分心行为（如：与其他行人交谈、吃喝东西/吸烟等）[5-10]。9篇文献来自美国。就所采用的研究方法而言，以实地观察最为常见，有13篇文献采用了此研究方法。样本量超过1 000例的研究有11篇。
采用不同研究方法和来自不同国家的研究中报告的行人分心发生率存在较大差异。其中，采用实地观察报告的行人过街使用手机、与其他行人交谈、吃喝东西/吸烟发生率分别为4.0%~43.2%、0.5%~7.4%和2.0%~15.7%。2013年阿根廷金融和商业区路口的行人手机使用发生率最低（4.0%）[10]，2005年美国大学校园内大学生步行的手机使用发生率最高（43.2%）[11]。此外，来自中国北京市、合肥市和澳大利亚昆士兰州的调查结果显示，行人在过去一周内过街时使用手机的报告发生率依次为78.4%（2015年）、40.0%（2017年）、20.0%（2017年）[3, 12-13]，而2016-2018年美国加利福尼亚州某医疗中心收治的遭遇交通事故的行人患者中约有16.5%在当次事故发生前使用手机、与其他行人交谈或吃喝东西[8]。
但上述研究多针对手机使用分心，缺乏纵向数据反映行人分心造成的伤害发生率、死亡率及其动态变化趋势，无法为制定针对性干预措施提供支持。
2. 行人分心的影响因素：共10篇文献报告了行人分心的影响因素及其效应量[3, 5, 8, 12, 17-19, 21-23]，主要涉及人口学特征、社会心理和环境3类影响因素（表 1）。其中，6篇文献仅研究了手机使用分心的影响因素，5篇文献采用问卷调查分析了行人分心的社会心理因素，另有5篇文献采用实地观察分析了人口学特征和环境对行人分心的影响。
其中，年龄 < 60岁（RR=10.4~17.6）、态度得分高（RR=1.2~2.3）、分心意图强（RR=1.4~2.5）是行人分心的最主要人口学和社会心理危险因素；有人行横道和十字路口标志（RR=2.5）、车行绿灯（RR=4.9）、气温 > 10 ℃（RR=2.1）是行人分心的常见环境危险因素（表 1）。
但是，上述研究主要针对手机使用分心或分心意图，缺乏全面探讨人口学特征、社会心理和环境3类因素对不同类型行人分心的共同影响，难以为制定各类行人分心的综合性干预措施提供依据。
3. 行人分心对过街安全的影响：2005-2021年共获得20篇行人分心对过街安全影响的文献[4, 6-7, 11, 14, 19, 24-37]。现有文献表明，行人分心可能通过对生理认知、运动控制、过街效率和过街行为造成不同程度的影响，增加人-车冲突、交通事故或临近交通事故的发生风险（表 2）。来自中国武汉市的实地观察和美国的虚拟现实研究结果显示，分心行人的人-车冲突次数[19]、交通事故/临近交通事故发生率分别较不分心行人增加了58.3%~241.7%、37.5%~691.0%（P < 0.05）[4, 25, 27, 29]。
但上述研究中仅5项采用交通事故发生率等直接指标作为行人分心对过街安全影响的结局指标[4, 19, 25, 27, 29]，且均为针对手机使用分心的小样本量（< 100例）、实验性研究，难以反映真实交通环境中不同类型行人分心对过街安全的直接影响。
4. 行人分心的干预措施：本研究共纳入10篇行人分心的干预措施文献，获得23项干预措施[9, 37-45]。现有干预措施多针对手机使用，以工程干预（52.2%）为主，其次为教育干预（26.1%）和立法干预（21.7%）。大多干预措施未经过严格的效果评价（16项，69.6%）（表 3）。
（1）工程干预：2005-2021年文献中共报告12项工程干预措施。其中，仅6项工程干预措施的效果被评估。大多数评价研究采用小样本随机对照实验设计（样本量为24~48例）[37, 39, 41, 43]，仅2项采用大样本量的实地观察研究（> 1 000例）[9, 42]。评价结果显示，路面警示灯/标语可吸引分心行人的注意力[37, 41]，对降低行人分心发生率具有一定的短期效应，但干预4个月后行人分心发生率与基线的差异无统计学意义（P > 0.05）[9, 42]。此外，发送警示短信可增加与车辆间的安全距离（OR=1.1，P < 0.05）和过街前等待时间（OR=1.9，P < 0.05），但可能会降低行人对交通环境的关注度（OR=0.6，P < 0.05）[43]（表 3）。
（2）教育与立法干预：文献中共报告6项教育和5项立法措施。其中，行人分心教育的设计未参考任何行为改变理论，且大多未经过严格的效果评估。仅美国的1项虚拟现实研究评价了行人过街分心危险性体验式教育的干预效果，结果显示干预后大学生自报的过街经常分心的风险降低（OR=0.8，P < 0.05），但实际观察到的过街分心发生率与未干预组之间的差异无统计学意义（OR=0.9~1.1，P > 0.05）[44]（表 3）。
综上所述，现有行人分心干预措施效果十分有限[9, 37-45]，且缺乏工程、教育、立法相结合的综合性干预措施，难以有效降低行人分心发生率。
5. 结论与建议：全球范围内行人分心发生率高，已成为一个重要的全球性公共卫生问题。行人分心主要受人口学特征、社会心理和环境3类因素影响，并通过影响生理认知、运动控制、过街效率和过街行为等机制威胁行人过街的安全性。然而，当前全球已发表文献中缺乏经过严格评估的有效干预措施。
据此，本文提出3点建议：①应针对常见行人分心开展高质量的流行病学研究和纵向监测，深入探讨常见行人分心发生率、各类影响因素的综合效应、真实交通环境下各类行人分心对过街安全的威胁及其动态变化趋势；②综合伤害预防、交通工程学、管理学等多学科理论与技术，精准设计和严格评估行人分心干预措施；③政府部门和相关专业技术机构应基于最新研究证据，制定针对性防控对策和配套保障策略，从立法、教育和工程干预等角度降低行人分心发生风险。
利益冲突 所有作者声明无利益冲突
参考文献
| [1] |
国家统计局. 互联网普及率[DB/OL]. [2021-06-16]. https://data.stats.gov.cn/search.htm?s=%E4%BA%92%E8%81%94%E7%BD%91. National Bureau of Statistics of China. Internet penetration rate[DB/OL]. [2021-06-16]. https://data.stats.gov.cn/search.htm?s=%E4%BA%92%E8%81%94%E7%BD%91. |
| [2] |
国家统计局. 民用汽车拥有量[DB/OL]. [2021-06-16]. https://data.stats.gov.cn/search.htm?s=%E6%B1%BD%E8%BD%A6. National Bureau of Statistics of China. Civil car ownership[DB/OL]. [2021-06-16]. https://data.stats.gov.cn/search.htm?s=%E6%B1%BD%E8%BD%A6. |
| [3] |
Lennon A, Oviedo-Trespalacios O, Matthews S. Pedestrian self-reported use of smart phones: positive attitudes and high exposure influence intentions to cross the road while distracted[J]. Accid Anal Prev, 2017, 98: 338-347. DOI:10.1016/j.aap.2016.10.028 |
| [4] |
Schwebel DC, Stavrinos D, Byington KW, et al. Distraction and pedestrian safety: how talking on the phone, texting, and listening to music impact crossing the street[J]. Accid Anal Prev, 2012, 45: 266-271. DOI:10.1016/j.aap.2011.07.011 |
| [5] |
Hamann C, Dulf D, Baragan-Andrada E, et al. Contributors to pedestrian distraction and risky behaviours during road crossings in Romania[J]. Inj Prev, 2017, 23(6): 370-376. DOI:10.1136/injuryprev-2016-042219 |
| [6] |
Wells HL, McClure LA, Porter BE, et al. Distracted pedestrian behavior on two urban college campuses[J]. J Community Health, 2018, 43(1): 96-102. DOI:10.1007/s10900-017-0392-x |
| [7] |
Bungum TJ, Day C, Henry LJ. The association of distraction and caution displayed by pedestrians at a lighted crosswalk[J]. J Community Health, 2005, 30(4): 269-279. DOI:10.1007/s10900-005-3705-4 |
| [8] |
Le B, Figueroa C, Anderson C, et al. Determining the incidence of distraction among trauma patients in all modes of transportation[J]. J Trauma Acute Care Surg, 2019, 87(1): 87-91. DOI:10.1097/TA.0000000000002293 |
| [9] |
Violano P, Roney L, Bechtel K. The incidence of pedestrian distraction at urban intersections after implementation of a streets smarts campaign[J]. Inj Epidemiol, 2015, 2(1): 18. DOI:10.1186/s40621-015-0050-7 |
| [10] |
Poó FM, Ledesma RD, Trujillo R. Pedestrian crossing behavior, an observational study in the city of Ushuaia, Argentina[J]. Traffic Inj Prev, 2018, 19(3): 305-310. DOI:10.1080/15389588.2017.1391380 |
| [11] |
Nasar J, Hecht P, Wener R. Mobile telephones, distracted attention, and pedestrian safety[J]. Accid Anal Prev, 2008, 40(1): 69-75. DOI:10.1016/j.aap.2007.04.005 |
| [12] |
Jiang K, Ling FY, Feng ZX, et al. Psychological predictors of mobile phone use while crossing the street among college students: an application of the theory of planned behavior[J]. Traffic Inj Prev, 2017, 18(2): 118-123. DOI:10.1080/15389588.2016.1236195 |
| [13] |
赵艳, 刘东, 王竞雄. 北京市行人过街使用手机对交通安全影响研究[J]. 中国人民公安大学学报: 自然科学版, 2015(2): 58-62. Zhao Y, Liu D, Wang JX. Study on the impact of pedestrian mobile phones use on traffic safety in Beijing[J]. J Chin People's Public Secur Univ: Sci Technol, 2015(2): 58-62. |
| [14] |
Thompson LL, Rivara FP, Ayyagari RC, et al. Impact of social and technological distraction on pedestrian crossing behaviour: an observational study[J]. Inj Prev, 2013, 19(4): 232-237. DOI:10.1136/injuryprev-2012-040601 |
| [15] |
Basch CH, Ethan D, Zybert P, et al. Pedestrian behavior at five dangerous and busy Manhattan intersections[J]. J Community Health, 2015, 40(4): 789-792. DOI:10.1007/s10900-015-0001-9 |
| [16] |
Nasar JL, Troyer D. Pedestrian injuries due to mobile phone use in public places[J]. Accid Anal Prev, 2013, 57: 91-95. DOI:10.1016/j.aap.2013.03.021 |
| [17] |
Quon P, Lahey K, Grisdale M, et al. Prevalence of distracted walking with mobile technology: an observational study of Calgary and Edmonton high school students[J]. Can J Public Health, 2019, 110(4): 506-511. DOI:10.17269/s41997-019-00200-9 |
| [18] |
Basch CH, Ethan D, Rajan S, et al. Technology-related distracted walking behaviours in Manhattan's most dangerous intersections[J]. Inj Prev, 2014, 20(5): 343-346. DOI:10.1136/injuryprev-2013-041063 |
| [19] |
张存保, 陈峰, 韦媛媛, 等. 无信号控制路段手机对行人过街行为和安全的影响[J]. 交通运输系统工程与信息, 2018, 18(2): 136-141. Zhang CB, Chen F, Wei YY, et al. The effects of mobile phone on pedestrian crossing behavior and safety at uncontrolled mid-block crosswalks[J]. J Transp Syst Eng Inf Technol, 2018, 18(2): 136-141. DOI:10.16097/j.cnki.1009-6744.2018.02.021 |
| [20] |
Ropaka M, Nikolaou D, Yannis G. Investigation of traffic and safety behavior of pedestrians while texting or web-surfing[J]. Traffic Inj Prev, 2020, 21(6): 389-394. DOI:10.1080/15389588.2020.1770741 |
| [21] |
Piazza AJ, Knowlden AP, Hibberd E, et al. Mobile device use while crossing the street: Utilizing the theory of planned behavior[J]. Accid Anal Prev, 2019, 127: 9-18. DOI:10.1016/j.aap.2019.02.006 |
| [22] |
Hou MY, Cheng JC, Xiao F, et al. Distracted behavior of pedestrians while crossing street: a case study in China[J]. Int J Environ Res Public Health, 2021, 18(1): 353. DOI:10.3390/ijerph18010353 |
| [23] |
Koh HE, Oh J, Mackert M. Predictors of playing augmented reality mobile games while walking based on the theory of planned behavior: web-based survey[J]. JMIR Mhealth Uhealth, 2017, 5(12): e191. DOI:10.2196/mhealth.8470 |
| [24] |
Lamberg EM, Muratori LM. Cell phones change the way we walk[J]. Gait Posture, 2012, 35(4): 688-690. DOI:10.1016/j.gaitpost.2011.12.005 |
| [25] |
Stavrinos D, Byington KW, Schwebel DC. Distracted walking: cell phones increase injury risk for college pedestrians[J]. J Safety Res, 2011, 42(2): 101-107. DOI:10.1016/j.jsr.2011.01.004 |
| [26] |
Agostini V, Lo Fermo F, Massazza G, et al. Does texting while walking really affect gait in young adults?[J]. J Neuroeng Rehabil, 2015, 12(1): 86. DOI:10.1186/s12984-015-0079-4 |
| [27] |
Stavrinos D, Byington KW, Schwebel DC. Effect of cell phone distraction on pediatric pedestrian injury risk[J]. Pediatrics, 2009, 123(2): e179-185. DOI:10.1542/peds.2008-1382 |
| [28] |
Banducci SE, Ward N, Gaspar JG, et al. The effects of cell phone and text message conversations on simulated street crossing[J]. Hum Factors, 2016, 58(1): 150-162. DOI:10.1177/0018720815609501 |
| [29] |
Byington KW, Schwebel DC. Effects of mobile internet use on college student pedestrian injury risk[J]. Accid Anal Prev, 2013, 51: 78-83. DOI:10.1016/j.aap.2012.11.001 |
| [30] |
Jiang K, Ling FY, Feng ZX, et al. Effects of mobile phone distraction on pedestrians' crossing behavior and visual attention allocation at a signalized intersection: an outdoor experimental study[J]. Accid Anal Prev, 2018, 115: 170-177. DOI:10.1016/j.aap.2018.03.019 |
| [31] |
Hatfield J, Murphy S. The effects of mobile phone use on pedestrian crossing behaviour at luetooth and luetooth ed intersections[J]. Accid Anal Prev, 2007, 9(1): 197-205. DOI:10.1016/j.aap.2006.07.001 |
| [32] |
Feld JA, Plummer P. Visual scanning behavior during distracted walking in healthy young adults[J]. Gait Posture, 2019, 67: 219-223. DOI:10.1016/j.gaitpost.2018.10.017 |
| [33] |
Chen PL, Pai CW. Pedestrian smartphone overuse and inattentional blindness: an observational study in Taipei, Taiwan[J]. BMC Public Health, 2018, 18(1): 1342. DOI:10.1186/s12889-018-6163-5 |
| [34] |
Tapiro H, Oron-Gilad T, Parmet Y. Pedestrian distraction: the effects of road environment complexity and age on pedestrian's visual attention and crossing behavior[J]. J Safety Res, 2020, 72: 101-109. DOI:10.1016/j.jsr.2019.12.003 |
| [35] |
Licence S, Smith R, McGuigan MP, et al. Gait pattern alterations during walking, texting and walking and texting during cognitively distractive tasks while negotiating common pedestrian obstacles[J]. PLoS One, 2015, 10(7): e0133281. DOI:10.1371/journal.pone.0133281 |
| [36] |
Lin MIB, Huang YP. The impact of walking while using a smartphone on pedestrians' awareness of roadside events[J]. Accid Anal Prev, 2017, 101: 87-96. DOI:10.1016/j.aap.2017.02.005 |
| [37] |
Kim E, Kim H, Kwon Y, et al. Performance of ground-level signal detection when using a phone while walking[J]. Accid Anal Prev, 2021, 151: 105909. DOI:10.1016/j.aap.2020.105909 |
| [38] |
交通言究社. 治理行人"低头族"看其他国家有何高招[J]. 汽车与安全, 2018(2): 67-69. Traffic Research Center. See what other countries have to do to curb the "phubbers"[J]. Auto Safety, 2018(2): 67-69. DOI:10.3969/j.issn.1006-6713.2018.02.023 |
| [39] |
何永明, 尚庆鹏, 王爽. 城市行人过街交通安全警示系统研究[J]. 交通科技与经济, 2018, 20(4): 9-12. He YM, Shang QP, Wang S. Traffic safety warning system of urban pedestrian crossing the street[J]. Technol Econ Areas Commun, 2018, 20(4): 9-12. DOI:10.19348/j.cnki.issn1008-5696.2018.04.003 |
| [40] |
Schwebel DC, Hasan R, Griffin R. Using bluetooth beacon technology to reduce distracted pedestrian behaviour: a cross-over trial study protocol[J]. Inj Prev, 2020, 26(3): 295-298. DOI:10.1136/injuryprev-2019-043436 |
| [41] |
Larue GS, Watling CN, Black AA, et al. Pedestrians distracted by their smartphone: are in-ground flashing lights catching their attention? A laboratory study[J]. Accid Anal Prev, 2020, 134: 105346. DOI:10.1016/j.aap.2019.105346 |
| [42] |
Barin EN, McLaughlin CM, Farag MW, et al. Heads up, phones down: a pedestrian safety intervention on distracted crosswalk behavior[J]. J Community Health, 2018, 43(4): 810-815. DOI:10.1007/s10900-018-0488-y |
| [43] |
Rahimian P, O'Neal EE, Zhou SW, et al. Harnessing vehicle-to-pedestrian (V2P) communication technology: sending traffic warnings to texting pedestrians[J]. Hum Factors, 2018, 60(6): 833-843. DOI:10.1177/0018720818781365 |
| [44] |
Schwebel DC, McClure LA, Porter BE. Experiential exposure to texting and walking in virtual reality: a randomized trial to reduce distracted pedestrian behavior[J]. Accid Anal Prev, 2017, 102: 116-122. DOI:10.1016/j.aap.2017.02.026 |
| [45] |
Mwakalonge J, Siuhi S, White J. Distracted walking: examining the extent to pedestrian safety problems[J]. J Traff Transp Eng (Engl Ed), 2015, 2(5): 327-337. DOI:10.1016/j.jtte.2015.08.004 |