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      Epidemiological characteristics and burden of childhood and adolescent injuries: a survey of elementary and secondary students in Xiamen, China

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          Abstract

          Background

          Injuries pose a considerable threat to the health of children and adolescents, and childhood injuries cause substantial economic loss for families and society. Many injuries are preventable. To provide a theoretical basis and empirical support for injury prevention interventions, we studied the epidemiological characteristics, risk factors, and burden of injuries among elementary and secondary school students in Xiamen, China.

          Methods

          Participants were enrolled through multi-stage stratified cluster random sampling of elementary and secondary students in Xiamen in 2010. Questionnaires were completed by students’ parents or guardians to assay students’ basic information, family background, occurrence of injuries in the past year, and burden of injuries. Chi-square tests and logistic regression were performed to identify the key factors of injuries.

          Results

          A total of 2,816 usable questionnaires reported 365 injury incidents in 303 students over 1 year. The incidence of injuries was 10.8%. Students who were male, extroverted, suburban, had sibling(s), studied in grades 4–9, or whose parents were divorced or separated were more likely to suffer from injuries. Most injuries occurred during the summer months (from June to August), and in the afternoon. The main affected body parts were limbs, fingers or toes. Unintentional falls, collisions/strikes, sprains, and cuts/sharp instrument injuries were the predominant causes of injury. The overall economic burden of the 365 injury incidents was 1,014,649.1 RMB (148,666.5 USD) total, 3,348.7 RMB (490.65 USD) per capita, and 2,779.9 RMB (407.31 USD) per incident.

          Conclusion

          The injury incidence among elementary and secondary students in Xiamen, China is lower than Guangdong and Zhejiang but higher than Beijing and Shanghai. Injuries caused substantial economic and family burdens and threatened students’ health and life. Childhood and adolescent injuries have become a serious public health problem that requires the urgent attention of the government, society, schools, and families. Injury control and prevention among elementary and secondary school students is essential and will help in multiple ways to reduce the burden on the family to build a harmonious family and society.

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          Most cited references25

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          World report on child injury prevention.

          L Sminkey (2008)
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            Exercise-based injury prevention in child and adolescent sport: a systematic review and meta-analysis.

            The promotion of sport and physical activity (PA) for children is widely recommended to support a healthy lifestyle, but being engaged in sport bears the risk of sustaining injuries. Injuries, in turn, can lead to a reduction in current and future involvement in PA and, therefore, may negatively affect future health as well as quality of life. Thus, sports injury prevention is of particular importance in youth.
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              Incidence and costs of 1987-1994 childhood injuries: demographic breakdowns.

              Injuries pose a threat to health and well-being and are a major source of medical spending in the United States for children and youth 0 to 21 years of age. This study provides national estimates of the incidence of fatal and nonfatal childhood injuries and comprehensive cost estimates by age, gender, race, family income, metropolitan residence, and place of incident. Eight years of National Health Interview Survey data (1987 to 1994) were used to estimate nonfatal injury incidence rates among children and youth 21 years of age and younger. The survey documents all medically attended or temporarily disabling injuries within the 2 weeks before the interview. Injuries were defined as diagnoses 800-995 in the International Classification of Diseases, Ninth Revision, excluding late effects cases. Fatality counts came from 1994 Vital Statistics. Estimates of the costs of injuries (1994 US dollars) included medical spending, lost future work, and lost quality of life. Medical payments included spending on hospital and professional services, rehabilitation, prescriptions, home health care, and medical equipment. Lost future work and lost quality of life consisted of the present value of work that children will be unable to do as adults if they are killed or permanently disabled combined with the pain and suffering that children and their families experience because of the injury. Cost estimates excluded parental income losses from work missed, property damage, legal costs, and insurance claims-adjustment costs related to permanent disability and death. INCIDENCE. A total of 3,073 injury episodes for 3,058 children were obtained from 8 years of National Health Interview Survey data. This represents 20.6 million children in the United States who were injured each year, or approximately 25 per 100 children. This translates to 56,000 nonfatal injury episodes each day that require medical attention or limit children's activity. For fatal injuries, the rate was 38 children per 100,000. The nonfatal injury rate for males (mean: 30; 95% confidence interval [CI]: 29,31) was higher than the rate for females (mean: 20; 95% CI: 19,21); the fatal injury rate for males was more than twice that of females. Injury rates increased with age. Children 0 to 9 years of age had the lowest rate of nonfatal injury. Rates for nonfatal injury among children 0 to 4 years of age were lower (mean: 20; 95% CI: 18,21) than those for the 5 to 9 age group (mean: 22; 95% CI: 20, 23). However, the rate for fatal injuries (21 per 100,000) among the 0 to 4 age group was higher than the 5 to 9 age group (9 per 100,000). Nonfatal injury rates for children 10 years of age and older were higher, with the highest estimated injury rates in late adolescence (15-19 years; mean: 31; 95% CI: 29,33). Nonfatal injuries occurred at higher rates among white children (mean: 27; 95% CI: 26,28) than black children (mean: 19; 95% CI: 17,21) or children from other racial backgrounds (mean: 13; 95% CI: 10,16). The reverse was true for fatal injuries, with higher fatality rates among black children (59 per 100,000). Children in families with incomes under $5,000 had the highest rate of nonfatal injury (mean: 31; 95% CI: 27,35), followed by those in the $35,000 to $49,999 income range (mean: 25; 95% CI: 23,27). The rate of nonfatal injuries in the other income brackets were fairly similar, with those in the highest income bracket having the lowest rate (mean: 14; 95% CI: 13,15). Fatality rates by family income were not available. The nonfatal injury rate in nonmetropolitan areas (mean: 10; 95% CI: 9,11) was higher than in metropolitan areas (mean: 8; 95% CI: 7,8); the same was true for fatal injury rates (33 per 100,000 in nonmetropolitan areas vs 25 in metropolitan areas). Males consistently had higher injury rates than females across all places of injury. Youth 15 years of age and older had higher rates for injuries that occur on the public roads, in recreatio
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                Author and article information

                Contributors
                fangya@xmu.edu.cn
                xiang@vt.edu
                chenw024@163.com
                502689824@qq.com
                yuanmanqiong1987@gmail.com
                linkin_sean@163.com
                859828508@qq.com
                xmdailong@163.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                10 April 2015
                10 April 2015
                2015
                : 15
                : 357
                Affiliations
                [ ]Key Laboratory of Health Technology Assessment in Fujian Province University, School of Public Health, Xiamen University, Xiamen, China
                [ ]State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
                [ ]Department of Statistics, School of Economics, Xiamen University, Xiamen, China
                [ ]Xiamen Institute for Healthcare of Middle and Primary Schools, Xiamen, China
                [ ]Division of Health Education, Xiamen Center for Disease Control, Xiamen, China
                Article
                1726
                10.1186/s12889-015-1726-1
                4395892
                25884937
                8023c795-11fa-4f37-9b60-a7d38cdfad9d
                © Fang et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 18 November 2014
                : 31 March 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                injury,elementary and secondary students,epidemiology,burden
                Public health
                injury, elementary and secondary students, epidemiology, burden

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