Background: In 2012, 76,000 pedestrians were struck by motor vehicles. This resulted in 20% of all pediatric mortalities between the ages of 5-15. We hypothesize that children are exposed to increased risk as pedestrians to motor vehicle injury when arriving to school and that identification of these hazards would improve targeting of injury prevention efforts. Methods: Within a county containing 355 public schools, we identified a primary school with 588 students located in an urban setting with concerns for a high risk traffic environment. Field surveys observed traffic patterns and established an optimal surveillance period 30 minutes before school. Three observation periods, from two discreet and blinded locations, were conducted from January-March, 2016. Videos were evaluated by two independent reviewers to identify and score quantifiable hazards. Three controlled observations were conducted on non-school days, followed by three post-intervention observations from October-December, 2016. Comparison was made utilizing a Student's t Test. Data was analyzed utilizing SAS(R) version 9.4(SAS Institute Inc., Cary, NC). Results: We identified nine safety hazards including double parking(29.3+/-5.5), dropping-off in a bus-stop(23.3+/-7.6), and jaywalking(9.3+/-3.1). Combining all hazards seen in each observation resulted in an overall hazard average of 83.0+/- 3.6 events/period. Comparing control periods to school observation identified significantly increased hazard events on school days(p
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