Non-fatal Unintentional Injuries Research Articles

Prevalence and correlates of unintentional nonfatal injuries among school-going adolescents in Central America.

The aim of this study is to report on the frequency of serious physical injuries (SPI) among adolescents in Central America during the previous decade, 2009-2018. In total, 15,807 school adolescents (14.4 years mean age; SD=1.4) from six Central American countries participated in cross-sectional Global School-based Student Health Surveys in 2009-2018 (ranging from 1,779 students in Honduras in 2012 to 4,374 students in Guatemala in 2015). The prevalence of SPI was 33.8 % (22.9 % once, 7.4 % 2 or 3 times and 3.6 % 4 or more times), ranging from 31.8 % in Guatemala to 45.0 % in Belize and 45.6 % in Panama. The most frequent causes of SPI included fall (11.4 %, ranging from 6.9 % in Costa Rica to 15.6 % in Panama), and the type of SPI was fracture/dislocation (5.7 %, ranging from 4.3 % in Costa Rica to 6.7 % in Panama). In adjusted Poisson regression, male sex,food insecurity, a history of alcohol intoxication, soft drink consumption, fast food intake, truancy, multiple sexual partners, psychological distress, physical fight, physically attacked, bullied, and suicide attempt were significantly associated with a higher number of injury event counts. Overall, about one in three adolescents in Central America had sustained unintentional injuries in the past 12months and several contributing factors were identified which if addressed could aid injury prevention among adolescents.

Sociodemographic distribution and correlates of nonfatal unintentional non-traffic-related injuries in Kenya: Results from the 2014 demographic and health survey.

Injuries are among the leading causes of mortality worldwide. There exists a paucity of nationally representative injury data from the sub-Saharan African region on the nature of injuries outside of road traffic contexts. The aim of this study was to estimate the prevalence of nonfatal unintentional injuries that occurred outside of the traffic environment among persons aged 15-54 years in Kenya. We used the 2014 Kenyan Demographic Health Survey data to estimate the prevalence of nonfatal unintentional injuries and their injury mechanisms. Binary logistic regression was used to estimate the odds of unintentional injuries and associated factors. Injury prevalence was three times higher among males (27.56%) compared to females (8.25%). The highest prevalence for females and males respectively was among those aged 15-19 years (9.80%) and (31.18%), rural residents (8.45%) and (30.05%) and those who consumed alcohol (18.13%), and (31.39%). For both females and males, the most frequent injuries were cuts (4.95%; 18.15%) and as result of falls (3.29%; 8.92%) respectively. Burns were more prevalent among females (1.65%) compared to males (0.76%). Among males, the demographic and contextual factors associated with nontraffic unintentional injuries were residing in a rural area (OR 1.33, 95% CI 1.14, 1.56), primary education (OR 2.02, 95% CI 1.48, 2.76), a higher wealth index (second quintile OR 1.41, 95% CI 1.19, 1.67) and consuming alcohol (OR 1.49, 95% CI 1.32, 1.69). Females who had completed primary, secondary (OR 2.43, 95% CI 1.92, 3.08) or higher education had higher odds of unintentional injuries. The findings mirror prior literature highlighting the clustering of demographic and behavioral factors which underlie predisposition to injuries outside of the traffic environment. Future nationally representative studies would benefit from deeper inquiry into and measurement of injury severity and health care utilization to inform strategic policy-relevant research.

Racial Disparities of Non-Fatal Unintentional Firearm Injuries in Children Requiring Hospitalization

Nofi, Colleen P MD; Roberts, Bailey MD; Kapoor, Sandeep MD; Harrison, Laura MPH; Dauber-Decker, Katherine PhD; Sathya, Chethan MD, MSc, FRCSC, FACS Author Information

Unintentional Injuries among Children with Developmental Disabilities are a Public Health Challenge in China.

Child injury is a significant global health issue that contributes to both morbidity and mortality in children. Children with developmental disabilities are at a high risk for injuries due to a combination of environmental barriers and health conditions. However, little research has assessed the prevalence of injuries among this population in China. Using administrative data from a micro insurance program for children with developmental disabilities (such as autism, intellectual disability, cerebral palsy, and Down syndrome) under the age of 19, we estimated the risk of unintentional injuries reported in insurance claims. Between 2017 and 2020, there were 190 insurance claims (0·53%) reporting nonfatal unintentional injuries and six reporting fatal injuries. The cumulative hazard rate of unintentional injuries by the end of one year is 1·21% and is negatively associated with children's age. These findings suggest the need for increased safety support for children with developmental disabilities, particularly in early childhood.

Defining the Full Spectrum of Pediatric Firearm Injury and Death in the United States: It is Even Worse Than We Think.

To characterize the full spectrum of pediatric firearm injury in the United States by describing fatal and nonfatal injury data epidemiology, vulnerable populations, and temporal trends. Firearm injury is the leading cause of death in children and adolescents in the United States. Nonfatal injury is critical to fully define the problem, yet accurate data at the national level are lacking. A cross-sectional study combining national firearm injury data from the Centers for Disease Control (fatal) and the National Trauma Data Bank (nonfatal) between 2008 and 2019 for ages 0 to 17 years. Data were analyzed using descriptive and χ 2 comparisons and linear regression. Approximately 5000 children and adolescents are injured or killed by firearms each year. Nonfatal injuries are twice as common as fatal injuries. Assault accounts for the majority of injuries and deaths (67%), unintentional 15%, and self-harm 14%. Black youth suffer disproportionally higher injuries overall (crude rate: 49.43/million vs White, non-Hispanic: 15.76/million), but self-harm is highest in White youth. Children <12 years are most affected by nonfatal unintentional injuries, 12 to 14 years by suicide, and 15 to 17 years by assault. Nonfatal unintentional and assault injuries, homicides, and suicides have all increased significantly ( P < 0.05). This study adds critical and contemporary data regarding the full spectrum and recent trends of pediatric firearm injury in the United States and identifies vulnerable populations to inform injury prevention intervention and policy. Reliable national surveillance for nonfatal pediatric firearm injury is vital to accurately define and tackle this growing public health crisis.

Prevalence and correlates of single and multiple unintentional non-fatal injuries among school-going adolescents in Liberia.

This investigation aims to report on single and multiple unintentional nonfatal injuries among in-school adolescents in Liberia. Nationally representative cross-sectional data were statistically analysed from 2,744 adolescents (median age=18 years) that participated in the 2017 Liberia Global School-Based Student Health Survey (GSHS). The prevalence of single or multiple serious injuries (past 12 months) was 71.6% (31.8% once and 39.7% two or more times). Struck or hit by an object (10.6%), fall (9.0%), and motor vehicle crashes (8.6%) were the most frequent causes of injury, and cuts or open wounds (13.6%), fractures or dislocation (8.2%), and concussion (5.0%) were the most prevalent types of injury. In adjusted multinomial logistic regression analysis, experience of hunger (or food insecurity), passive smoking, frequent school truancy, psychological distress, and current cannabis use were associated with multiple and/or single injury. In addition, in unadjusted analysis, current tobacco use, ever drunk, ever amphetamine use, physically inactive and sedentary and walking and biking to school were associated with single and/or multiple injuries. In a separate multinomial logistic regression model, victims of physically assault, involvement in physical fighting, and bullying victimization were associated with both single and multiple injuries. A high prevalence of unintentional single and multiple injuries was discovered and several factors were found that can be utilized in targeting programmes aimed at injury prevention among adolescents.

Serious non-fatal unintentional injuries among in-school adolescents in Sri Lanka: results from the 2016 Sri Lankan global school-based health survey

BackgroundUnintentional injuries among adolescents is a major public health problem the world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; it is also the leading cause of death among adolescents in the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13–17 years using data from the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka.MethodsA cross-sectional survey was conducted using a self-administered questionnaire, among 3262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected using probabilities proportional to school enrollment size, from all schools in the country that have classes in grades 8–12. Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. The weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates.ResultsDuring the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured one or more times. The injuries were more common among males, but were equally common among the two different age groups (13–15 age group vs 16–17 age group). The most common type of injury was cut or stab wounds (5.5%), followed by broken bones/dislocated joints (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as being of the male sex, being bullied, being physically attacked, and/or being in a physical fight.ConclusionThis study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration when designing school-based interventions to prevent adolescent injuries.

Burden of Lesser-Known Unintentional Non-Fatal Injuries in Rural Bangladesh: Findings from a Large-Scale Population-Based Study.

Around 90% of all fatal and non-fatal unintentional injuries occur in low- and middle-income countries (LMICs). The magnitude of unintentional injuries is unclear due to limited research and data. This paper describes the burden of lesser-known injuries (LKIs—cut injuries, unintentional poisoning, machine injuries, electrocution, injury by blunt objects, and suffocation) in rural Bangladesh, using data from the Saving of Lives from Drowning (SoLiD) project in Bangladesh. Descriptive statistics were used to report counts and rates of injuries by socio-demographic factors, injury characteristics, and circumstantial details. The annual morbidity rate of LKIs was 6878 injuries per 100,000 persons, involving 3.4% (40,520) of the population. Cut injury (44,131.2/100,000 per year) and injury by blunt objects (19768.6/100,000 per year) attributed in large numbers to the overall burden of LKIs. Males (66.1%) suffered more injuries than females. More than half (52.9%) occurred among people aged 25 to 64 years. Those involved in agriculture suffered the most injuries, mainly cut injuries (9234.1/100,000 per year) and machine-related injuries (582.9/100,000 per year). Most injuries occurred in the home setting. Increased awareness about packaging, storage, and the proper handling of appliances can help lower the frequency of LKIs. Safe architecture and awareness about home injuries is required to reduce injuries occurring in the home environment.

The effectiveness and cost-effectiveness of strength and balance Exergames to reduce falls risk for people aged 55\u2009years and older in UK assisted living facilities: a multi-centre, cluster randomised controlled trial

BackgroundFalls are the leading cause of fatal and non-fatal unintentional injuries in older people. The use of Exergames (active, gamified video-based exercises) is a possible innovative, community-based approach. This study aimed to determine the effectiveness of a tailored OTAGO/FaME-based strength and balance Exergame programme for improving balance, maintaining function and reducing falls risk in older people.MethodsA two-arm cluster randomised controlled trial recruiting adults aged 55 years and older living in 18 assisted living (sheltered housing) facilities (clusters) in the UK. Standard care (physiotherapy advice and leaflet) was compared to a tailored 12-week strength and balance Exergame programme, supported by physiotherapists or trained assistants. Complete case analysis (intention-to-treat) was used to compare the Berg Balance Scale (BBS) at baseline and at 12 weeks. Secondary outcomes included fear of falling, mobility, fall risk, pain, mood, fatigue, cognition, healthcare utilisation and health-related quality of life, and self-reported physical activity and falls.ResultsEighteen clusters were randomised (9 to each arm) with 56 participants allocated to the intervention and 50 to the control (78% female, mean age 78 years). Fourteen participants withdrew over the 12 weeks (both arms), mainly for ill health. There was an adjusted mean improvement in balance (BBS) of 6.2 (95% CI 2.4 to 10.0) and reduced fear of falling (p = 0.007) and pain (p = 0.02) in the Exergame group. Mean attendance at sessions was 69% (mean exercising time of 33 min/week). Twenty-four percent of the control group and 20% of the Exergame group fell over the trial period. The change in fall rates significantly favoured the intervention (incident rate ratio 0.31 (95% CI 0.16 to 0.62, p = 0.001)). The point estimate of the incremental cost-effectiveness ratio (ICER) was £15,209.80 per quality-adjusted life year (QALY). Using 10,000 bootstrap replications, at the lower bound of the NICE threshold of £20,000 per QALY, there was a 61% probability of Exergames being cost-effective, rising to 73% at the upper bound of £30,000 per QALY.ConclusionsExergames, as delivered in this trial, improve balance, pain and fear of falling and are a cost-effective fall prevention strategy in assisted living facilities for people aged 55 years or older.Trial registrationThe trial was registered at ClinicalTrials.gov on 18 Dec 2015 with reference number NCT02634736.

Leading Causes of Fatal and Nonfatal Unintentional Injury for Children and Teens and the Role of Lifestyle Clinicians: A Commentary.

Unintentional injury and death as a public health concern has not been established in the pediatric population. This is a commentary on a review of epidemiological data of unintentional deaths and injuries with a focus on age, sex, and racial differences in this population. The review takes in-depth look at children aged 0-19 years in the US, followed by a discussion of strategies suggested to address mechanisms of these injuries/deaths. Lifestyle clinicians have a significant role in educating this population and their parent/guardians. Therefore providing insight into the interpretation of the data can support practical education and prevention interventions.

Neighborhood Risk Factors for Pediatric Fall-Related Injuries: A Retrospective Analysis of a Statewide Hospital Network

BackgroundFalls represent the leading cause of nonfatal unintentional injuries among children in the United States. Although unintentional injury risks have been studied, neighborhood impact on falls remains underexplored. This study examined the association of neighborhood attributes with rates of fall-related injuries. MethodsThis is a retrospective study of children who presented to emergency departments within a statewide hospital network for fall-related injuries between 2005 and 2014. Patients’ home addresses were geocoded to identify US Census block groups (BGs). Average annual fall rates were computed for each BG. A neighborhood risk index was constructed using 8 socioeconomic BG measures (education, crowding, vacancy, renter occupancy, poverty, family structure, race/ethnicity, and housing age). Public outdoor recreational facilities in each BG were enumerated. Linear regression analysis was used to assess the association of neighborhood risk and recreational facilities with fall rates. ResultsFrom 2005 to 2014, there were 139,986 unintentional injury emergency department visits; of these, 42,691 (30%) were for falls. The largest proportion of falls were among males (58%), children ages 1 to 4 years (39%), non-Hispanic whites (59%), and children with public health insurance (53%). Higher quintiles of neighborhood risk were associated with higher annual fall rates compared to the lowest quintile of risk: quintile 2, β = 0.44, 95% confidence interval (CI), 0.20–0.68; quintile 3, β = 0.85, 95% CI, 0.61–1.10; quintile 4, β = 1.11, 95% CI, 0.85–1.37; quintile 5, β = 1.57, 95% CI, 1.29–1.85. The presence of public outdoor recreational facilities was not associated with fall rates (β = 0.01; 95% CI, –0.14 to 0.15). ConclusionNeighborhood-level socioeconomic characteristics are associated with higher fall-related injuries. Injury prevention programs could be tailored to address these neighborhood risks.

EXERGAMES TO REDUCE FALLS RISK IN OLDER PEOPLE IN UK ASSISTED LIVING FACILITIES: A MULTI-CENTRE, CLUSTER RCT

Falls are the leading cause of fatal and non-fatal unintentional injuries in older people. The use of Exergames (active video-games) is a possible innovative, community-based approach to reduce falls risk. The objective of this study was to evaluate the effectiveness of a tailored physiotherapy-based Exergame programme for reducing falls risk in older residents of assisted living facilities in the UK. A multi-site, two-arm cluster randomised controlled trial with 3 month follow up of falls in eighteen assisted-living facilities in the UK was conducted. Tailored 12-week strength and balance Exergame programme, supported by physiotherapists or assistants plus standard care (physio advice and leaflet) against standard care only, in older adults dwelling in assisted living facilities. The primary outcome measure was balance as assessed by the Berg Balance scale (BBS). Secondary outcomes included fear of falling, mobility, pain, falls risk, fatigue, cognition and incidence of falls. Eighteen sites were recruited and randomised to each intervention (106 participants of which 56 Exergames; 50 control). Intention-to-treat analysis revealed that balance was significantly improved at 12 wks in the Exergame group with an adjusted mean increase in BBS of 6.18 (95% CI 2.38 to 9.97) and significant improvements in secondary outcomes of fear of falling and pain. Falls rate was significantly lower in the Exergames group (incidence rate ratio 0.40, (95%CI 0.22 to 0.74, p=0.001). Exergames, as delivered in this trial, improve balance, pain and fear of falling and may be considered as a fall prevention strategy in assistive living facilities for older people.

The Effectiveness and Cost-Effectiveness of Strength and Balance Exergames to Reduce Falls Risk for Older People in UK Assisted Living Facilities: A Multi-Centre, Cluster Randomised Controlled Trial

Background: Falls are the leading cause of fatal and non-fatal unintentional injuries in older people. In the community, 30% of adults aged 65 fall per year. The use of Exergames (active video-based exercise games) is a possible innovative, community-based approach to improve balance and function, and thus reduce falls risk. Objective: To determine the effectiveness of a tailored OTAGO based strength and balance Exergame programme for improving balance, maintaining function and reducing falls risk in older residents of assisted living facilities in the UK. Design: A two-arm cluster randomised controlled trial. Participants and setting Adults aged 55 years and older living in 18 assisted-living (sheltered housing) facilities (clusters) in the UK. Interventions: Tailored 12-week strength and balance Exergame programme, supported by physiotherapists or trained assistants plus standard care (physiotherapy advice and leaflet) versus standard care only. Main outcome measures: The primary outcome measure was balance at 12 weeks post-baseline, as assessed by the Berg Balance Scale (BBS). Secondary outcomes included: fear of falling, mobility, self-reported physical activity, falls risk, pain, mood, fatigue, cognition, healthcare utilisation and health-related quality of life; and self-reported falls over a 3-month period. Randomisation and blinding Clusters were randomised in blocks of two after participants were recruited and baseline data were collected. No blinding of those delivering or receiving the interventions, collecting or analysing data was possible. Results: Eighteen clusters were randomised (9 to each arm) with 56 participants allocated to the intervention and 50 to the control condition (78% female, mean age 78 years). Fourteen participants withdrew over the 12 weeks, mainly due to ill health, drop out rates did not differ per arm. Intention-to-treat analysis of respondents (49 Exergames; 43 control) revealed that balance was significantly improved at 12 weeks in the Exergame group; adjusted mean improvement in balance (BBS) of 6.2 (95% CI 2.4 to 10.0) and significant improvements in falls rate (p=0.001), fear of falling (p=0.007) and pain (p=0.02).The mean attendance at Exergames sessions during 12 weeks was 69% with a mean exercising time of 33 minutes/week. In the control group 12 (24%) participants fell 38 times over 3 months compared to 11 (20%) participants of the Exergame group who fell 17 times. The change in falls rates significantly favoured the intervention (incident rate ratio 0.31 (95% CI 0.16 to 0.62, p=0.001)). The point estimate of the incremental cost effectiveness ratio (ICER) was £15,209.80 per QALY. Using 10,000 bootstrap replications, at the lower bound of the NICE threshold of £20,000 per QALY, there was a 61% probability of Exergames being cost-effective. This rose to 73% at the upper bound of £30,000 per QALY. Conclusion: Exergames, as delivered in this trial, improve balance, pain and fear of falling and are an effective fall prevention strategy in assisted living facilities for older people. Health economic analysis suggests that Exergames represent a cost-effective fall prevention strategy. Clinical Trial Registration: Trial Registration ClinicalTrials.gov: NCT02634736 Funding Statement: This study was funded by Innovate UK through their SBRI programme. LM acknowledges financial support from the MRC Skills Development Fellowship (MR/N015126/1). The authors would like to acknowledge the contributions of Ms Kelly Banham, Ms Margaret Clarke, Ms Tina Duckworth, Ms Megan Lloyd, Dr Katie Thomson, Dr Calum Leask, Trafford Housing Trust, Pennine Care NHS Falls Service (Ms Debra Maloney, Dr Jay Chillala, Ms Angela Easdon), Mr Bibhas Roy, Dr Richard Deed, Prof Jackie Oldham, Dr Mark Pilling, Ms Joanne Thomas, Ms Bernadette O’Dowd. Declaration of Interests: Dawn Skelton is a Director of Later Life Training, a not for profit training company that provides training in delivery of the Otago and FaME Programmes with the UK, Europe and Singapore. No other conflicts of interest are declared. Ethics Approval Statement: Ethics approvals for this study were obtained from London - Camden & Kings Cross Research Ethics Committee, reference number 16/LO/0200.

The Epidemiology of Unintentional and Violence-Related Injury Morbidity and Mortality among Children and Adolescents in the United States.

Injuries and violence among young people have a substantial emotional, physical, and economic toll on society. Understanding the epidemiology of this public health problem can guide prevention efforts, help identify and reduce risk factors, and promote protective factors. We examined fatal and nonfatal unintentional injuries, injuries intentionally inflicted by other (i.e., assaults and homicides) among children ages 0–19, and intentionally self-inflicted injuries (i.e., self-harm and suicides) among children ages 10–19. We accessed deaths (1999–2015) and visits to emergency departments (2001–2015) for these age groups through the Centers for Disease Control and Prevention’s (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS), and examined trends and differences by age, sex, race/ethnicity, rural/urban status, and injury mechanism. Almost 13,000 children and adolescents age 0–19 years died in 2015 from injury and violence compared to over 17,000 in 1999. While the overall number of deaths has decreased over time, there were increases in death rates among certain age groups for some categories of unintentional injury and for suicides. The leading causes of injury varied by age group. Our results indicate that efforts to reduce injuries to children and adolescents should consider cause, intent, age, sex, race, and regional factors to assure that prevention resources are directed at those at greatest risk.

Child injuries in Ethiopia: A review of the current situation with projections.

BackgroundHeavy burden of child injuries and lack of policy response in Ethiopia call for an improved understanding of the situation and development of action plans from multiple governmental agencies and stakeholders.MethodsA consortium of international and Ethiopian researchers and stakeholders used extensive literature review and mixed analytical methods to estimate and project the burden of fatal and non-fatal child unintentional injuries in Ethiopia from 2015 to 2030. Estimates were derived for children aged 0–14 years. Data sources include a longitudinal study conducted by the Central Statistics Agency of Ethiopia and the World Bank as well as model-based estimates from World Health Organization 2017 and Global Burden of Disease 2016 project.ResultsInjuries caused about 25 thousand deaths among 0-14-year olds in Ethiopia in 2015. The leading cause of fatal child unintentional injuries in Ethiopia was road-traffic injuries, followed by fire, heat and hot substances and drowning. The death rate due to injuries among 0–14 years olds was about 50 percent higher in males than females. Rural children were exposed to a greater risk of injury than their urban peers. The longitudinal survey suggests that the incidence rate of child injuries increased during the period 2011–2014. The annual mortality caused by injuries is projected to increase from 10,697 in 2015 to 11,279 in 2020 and 11,989 in 2030 among children under 5 years, an increase of 12 percentage points in 15 years. The number of deaths among 0-14-year olds will be 26,463, 27,807, and 30,364 respectively in 2015, 2020, and 2030.ConclusionsAs the first multisectoral collaboration on child injuries in Ethiopia, this study identified gaps in understanding of the burden of child injuries in Ethiopia. In consultation with Ethiopian government and other stakeholders, we propose starting an injury surveillance system at health clinics and hospitals and building an intervention package based on existing platforms.

Leading Causes of Fatal and Nonfatal Unintentional Injury for Children and Teens and the Role of Lifestyle Clinicians.

About 1 in 5 child deaths is a result of unintentional injury. The leading causes of unintentional injury death vary by age. This report provides national fatal and nonfatal data for children and teens by age, sex, and race/ethnicity. Prevention strategies for the most common causes are highlighted. Opportunities for lifestyle clinicians to effectively guide their patients and their parents are discussed.

Risk factors of Non-fatal Unintentional Home Injuries among Children under 5 Years Old; a Population-Based Study.

In addition to the annual mortality rate, unintentional home injury may result in temporary or permanent disability and requires medical attention and continuous care in millions of children. This study aimed to explore features and risk factors of these injuries. In this cross-sectional study, demographic variables and epidemiologic pattern of home injuries among children under 5 years of age were collected via a population-based survey in seven main cities of Khuzestan province, southwest Iran, during September 2011 to December 2012. Developing a risk stratification model, independent risk factors of unintentional home injury were determined and put to multivariate logistic regression analysis. 2693 children with the mean age of 27.36 ± 15.55 months (1 to 60) were evaluated (50.9% boy). 827 (30.7%) cases had a history of at least one home injury occurrence since birth to study time. The most common injury mechanisms were burning with 291 (38.4%) cases, falling with 214 (28.3%) and poisoning with 66 (8.7%) cases, respectively. The independent risk factors of unintentional home injury were age ≥ 24 month (p<0.001), residency in Ahvaz city (p<0.001), mother's illiteracy (p<0.014), ethnicity (p<0.001), private housing (p=0.01), birth weight (p<0.001), and being the first child (p=0. 01). Sensitivity, specificity, and area under the ROC curve of the model designed by multivariate analysis were 53.5%, 84.8%, and 0.75 (95% CI: 0.73- 0.77; P < 0.001, figure 1), respectively. According to the findings of this study, 30.7% of the studied children were injured at least once since birth. Burning, falling, poisoning, swallowing objects, choking, and biting were the main home injury mechanisms. Age ≥ 24 months, being the first child, living in a private house, being a resident of Ahvaz city, and having an illiterate mother were found to be risk factors of home injury.

Child safety and injury prevention.

1. Jennifer E. Sanders, MD 2. Leora Mogilner, MD 1. Icahn School of Medicine at Mount Sinai, New York, NY 1. 1. Hagan JF, 2. Shaw JS, 3. Duncan PM Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents , 3rd ed. Hagan JF, Shaw JS, Duncan PM, eds. Elk Grove Village, IL: American Academy of Pediatrics; 2008 2. In-Line Skating Injuries in Children and Adolescents. American Academy of Pediatrics Committee on Injury and Poison Prevention and Committee on Sports Medicine and Fitness. Pediatrics. 1998;101(4):720–722 [OpenUrl][1][Abstract/FREE Full Text][2] 3. Child Passenger Safety. American Academy of Pediatrics Committee on Injury, Violence and Poison Prevention. Pediatrics. 2011;127(4):788–792 [OpenUrl][3][Abstract/FREE Full Text][4] 4. SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment . Task Force on Sudden Infant Death Syndrome. Pediatrics. 2011;128(5):1030–1039 [OpenUrl][5][Abstract/FREE Full Text][6] 5. National Action Plan for Child Injury Prevention . Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Atlanta, GACDC, NCIPC; 2012 Unintentional injuries are the leading cause of death in the United States among children older than 1 year of age, adolescents, and young adults. Each year, nearly 9 million pediatric patients are treated in emergency departments for unintentional injuries, and more than 9,000 die from their injuries, amounting to approximately 25 children each day. Common causes of fatal and nonfatal unintentional injury include motor vehicle collisions, drownings, fires, falls, and sports-related injuries. Aside from their morbidity and mortality, these injuries and their treatment result in significant financial burdens for families and society. Children and adolescents are particularly vulnerable to injury because of their size, immature development, natural curiosity, and inexperience. Males have a higher risk of injury compared to females, and the male death rate from injury is twice that of females. A number of social factors suggestive of family stress and disorganization are associated with greater childhood injury, including lower socioeconomic status, lower maternal age, lower maternal education, and an increased number of people living in one household. Injury rates also vary based on geographic location. Fire and burn-related injuries and deaths are greatest in the southern states, while traffic-related injuries are greatest in the Great Plains states and the South. Motor vehicle crashes are a leading cause of preventable deaths across all age groups. Patient visits … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft.stitle%253DPediatrics%26rft.aulast%253DCommittee%2Bon%2BInjury%2Band%2BPoison%2BPrevention%2Band%2BComm%26rft.auinit1%253D%2B%26rft.volume%253D101%26rft.issue%253D4%26rft.spage%253D720%26rft.epage%253D722%26rft.atitle%253DIn-line%2BSkating%2BInjuries%2Bin%2BChildren%2Band%2BAdolescents%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.101.4.720%26rft_id%253Dinfo%253Apmid%252F9521966%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=101/4/720&atom=%2Fpedsinreview%2F36%2F6%2F268.atom [3]: {openurl}?query=rft.jtitle%253DPediatrics%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2011-0213%26rft_id%253Dinfo%253Apmid%252F21422088%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=127/4/788&atom=%2Fpedsinreview%2F36%2F6%2F268.atom [5]: {openurl}?query=rft.jtitle%253DPediatrics%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2011-2284%26rft_id%253Dinfo%253Apmid%252F22007004%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=128/5/1030&atom=%2Fpedsinreview%2F36%2F6%2F268.atom

Unintentional injuries in the German adult population. Results of the "German Health Update" survey 2010

In Germany, more than 20,000 people were killed in accidents and 8.7 million people suffered nonfatal unintentional injuries (UI) in 2011. This report gives an overview of the occurrence of nonfatal UI in the German adult population. The representative health survey "German Health Update" 2010 (phone survey) collected data on nonfatal accidents in the adult population within a recall period of 12months (n = 22,050). Interviewees reporting medically treated UI responded to 19 further questions about accident locations, accident mechanisms, injuries, and consequences of up to three UI within 1 year. Overall, detailed data on 2,117 UI were collected. About 7.9 % of the German adult population suffers at least one medically treated UI within 1 year. Men are more often affected than women and young people more frequently than older people. The majority of all UI occurs at home or during leisure-time activities. One in five UI results from accidents on public footways, roads, and squares. Falls account for almost every third UI and about one in five accidents causes fractures. Two thirds of all UI require inpatient treatment. Two in three UI lead to temporary sick leave averaging 29.7 days of absenteeism. Among UI at home and in leisure-time activities, falls have particularly serious consequences. Moreover, falls play an important role in UI among pedestrians and cyclists. UI affect large parts of the German adult population and are clearly patterned by gender, age, and accident location. Therefore, prevention activities should consider target group-specific needs and setting-specific circumstances of UI.

Type A personality, hostility, time urgency and unintentional injuries among Chinese undergraduates: a matched case–control study

BackgroundAssociations between type A behaviour pattern (TABP) and injuries are inconsistent. These inconsistencies may be due to different effects of various components of TABP, namely time urgency/impatience, hostility and competitive drive. It is important to examine the relationship between the global TABP, its two components, and unintentional injuries, among undergraduates in China.MethodsOn the basis of a previous cross-sectional study, we conducted a matched case–control study. 253 cases and an equal number of age-, gender-, and major-matched controls were included. The questionnaire solicited socio-demographic information, the experience of injuries, the scale of TABP, and other potential confounding factors. Besides the correlation between the global TABP and injuries, the influences of the two components of TABP on injuries were also evaluated. Conditional logistic regression was used to determine the crude odds ratios (ORs) and adjusted ORs of injury events.ResultsA dose–response relationship was apparent among students who rated themselves higher on the TABP scale (P-value for trend, 0.002), with a crude OR of 2.93 (95% CI: 0.93–9.19) for injuries comparing those with TABP to those with type B behaviour pattern (TBBP). After adjustment for potential confounding factors, TABP remained statistically significant, and the adjusted OR was 5.52 (95% CI: 1.43–21.27); from a comparison of students with TABP to those with TBBP. A dose–response relationship was also apparent between the hostility component and nonfatal injuries, both in crude analysis and after adjusting for other confounders. The relationship between time-hurry and injuries was not statistically significant, based on univariate and multivariate analyses.ConclusionsBoth the global TABP and the hostility component were associated with a dose response increase in the risk of non-fatal unintentional injuries among Chinese undergraduates. Further studies need to be conducted to confirm or reject this correlation.