Abstract
The aim of the study was to analyse the incidence of school accidents in relation to school size, urban/rural environment and conditions of physical education classes. 202 primary schools with nearly 50,000 students aged 7-15 years were studied during a 6-year period in the Włocławek region in Poland. There were in total 3274 school accidents per 293,000 student-years. Accidents during breaks (36.6%) and physical education (33.2%) were most common. Most frequently accidents took place at schoolyard (29.7%), gymnasium (20.2%), and in the corridor and stairs (25.2%). After adjustment for students' age and sex, student-staff ratio and duration of school hours, urban environment increased the probability of accident (OR: 1.25; 95% CI: 1.14-1.38). Middle-size schools (8-23 classes) had similar accident rate as small schools (OR: 0.93; 95% CI: 0.83-1.04), while schools with 24-32 classes (OR: 1.26; 95% CI: 1.10-1.43) and with > or = 33 classes (OR: 1.36; 95% CI: 1.17-1.58) had increased accident rate. Presence of a gymnasium was also associated with increased probability of accident (OR: 1.49; 95% CI: 1.38-1.61). Urban environment, larger school-size and equipment with full-size gymnasium are important and independent risk factors for school accidents. These findings provide some new insights into the epidemiology of school-related accidents and may be useful information for the planning of strategies to reduce accident incidence in schools.
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