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March 1989, Vol 143, No. 3 >
Article | March 1989

Recurrent Injuries in Schoolchildren FREE

W. Thomas Boyce, MD; Sue Sobolewski, RN, MPH
[+] Author Affiliations

Accepted for publication Nov 25, 1988.

Presented in part at the Ambulatory Pediatrics Association Annual Meeting, April 30, 1984.

Reprint requests to Division of Behavioral and Developmental Pediatrics, University of California, 400 Parnassus Ave, A203, San Francisco, CA 94143 (Dr Boyce).


Am J Dis Child. 1989;143(3):338-342. doi:10.1001/archpedi.1989.02150150096024.
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References
Comments

• Past work identifying "accident-prone" children with disproportionate rates of injury has been based on clinical data gathered in office, clinic, or emergency department settings. To avoid the biases inherent in such designs, we studied recurrent injuries in a school district population, utilizing a prospective surveillance system to identify injuries meeting standardized criteria. During three school years we observed 54 874 students, ranging in age from 6 to 18 years, for recurrent injuries, which were defined as those occurring in a year in which two or more injuries were reported for the child. Five hundred seventy-three recurrently injured children (1% of the school district population) sustained 1405 injuries (17% of the overall injury experience), a proportion significantly but only slightly greater than that expected on the basis of chance alone (14%). Most recurrently injured children were injured in only a single year, with only 15 children sustaining injuries in all three study years. Age, sex, and type of school were significant correlates of recurrent injury rates, with junior high school students, boys, and students attending schools with alternative educational programs having the highest rates of injury recurrence. The findings indicate that (1) a small group of schoolchildren sustain a disproportionate share of the overall injury experience, (2) the majority of recurrently injured children experience only transient periods of enhanced injury risk, and (3) preventive strategies may benefit from investigation of developmental and social environmental factors that alter such risk.

(AJDC 1989;143:338-342)

REFERENCES

1 +
World Health Organization:  Health of the world's children . WHO Chron 1979;;33:119-127.
2 +
Baker SP, O'Neill B, Karg R: The Injury Fact Book . Lexington, Ky, DC Heath & Co, 1984;.
3 +
Guyer B, Gallagher S:  An approach to the epidemiology of childhood injuries . Pediatr Clin North Am 1985;;32:5-15.
4 +
Vital and Health Statistics: Current Estimates from the National Health Interview Survey , Department of Health and Human Services publication 82-1567, Hyattsville, Md, National Center for Health Statistics, 1981;.
5 +
Rivara FP, Bergman AB, LoGerfo JP, et al:  Epidemiology of childhood injuries: Sex differences in injury rates . AJDC 1982;;136:502-506.
6 +
Rivara FP:  Epidemiology of childhood injuries: I. Review of current research and presentation of conceptual framework . AJDC 1982;;136: 399-405.
7 +
Baker SP:  Determinants of injury and opportunities for intervention . Am J Epidemiol 1975;;101:98-102.
8 +
Pless IB, Stulginskas J:  Accidents and violence as a cause of morbidity and mortality in childhood . Adv Pediatr 1982;;29:471-495.
9 +
Boyce WT, Sprunger LW, Sobolewski S, et al:  Epidemiology of injuries in a large, urban school district . Pediatrics 1984;;74:342-349.
10 +
Sheps SB, Evans GD:  Epidemiology of school injuries: A two-year experience in a municipal health department . Pediatrics 1987;;79:69-75.
11 +
Feldman W, Woodward CA, Hodgson C, et al:  Prospective study of school injuries: Incidence, types, related factors and initial management . Can Med Assoc J 1983;;129:1279-1283.
12 +
Schor EL:  Use of health care services by children and diagnoses received during presumably stressful life transitions . Pediatrics 1986;;77: 834-841.
13 +
Schinke SP, Schilling FR, Snow WH:  Stress management with adolescents at the junior high transition: An outcome evaluation of coping skills intervention . J Human Stress 1987;;13:16-22.
14 +
Chang A, Lugg MM, Nedebum A: Injuries in preschool children enrolled in day care centers. Pediatrics. In press.
15 +
Bijur PE, Stewart-Brown S, Butler N:  Child behavior and accidental injury in 11 966 preschool children . AJDC 1986;;140:487-492.
16 +
Gallagher SS, Finison K, Guyer B, et al:  The incidence of injuries among 87 000 Massachusetts children and adolescents: Results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System . Am J Public Health 1984;;74:1340-1347.
17 +
Manheimer DI, Mellinger GD:  Personality characteristics of the child accident repeater . Child Dev 1967;;38:491-513.
18 +
Froggatt P, Smiley JA:  The concept of accident proneness: A review . Br J Indust Med 1964;;21:1-12.
19 +
Connolly J:  Accident proneness . Br J Hosp Med 1981;;26:470-479.
20 +
Sass R, Crook G:  Accident proneness: Science or non-science? Int J Health Serv 1981;;11: 175-190.
21 +
Farmer E, Chambers EG: A psychological study of individual differences in accident rates . London, Industrial Fatigue Research Board, report No. (38) , 1926;.
22 +
Langley J, Silva PA, Williams S:  A study of the relationship of 90 background developmental behavioural and medical factors to childhood accidents: A report from the Dunedin Multidisciplinary Child Development Study . Aust Paediatr J 1980;;16:244-247.
23 +
Langley J:  The 'accident prone' child: The perpetration of a myth . Aust Paediatr J 1982;; 18:243-246.
24 +
Langley J, McGee R, Silva P, et al:  Child behavior and accidents . J Pediatr Psychol 1983;;8:181-189.
25 +
Langley J, Dodge J, Silva PA:  Accidents in the first five years of life: A report from the Dunedin Multidisciplinary Child Development Study . Aust Paediatr J 1979;;15:255-259.
26 +
Husband P:  The accident-prone child . Practitioner 1973;;211:335-344.
27 +
Eminson CJ, Jones H, Goldacre M:  Repetition of accidents in young children . J Epidemiol Community Health 1986;;40:170-173.
28 +
Jones JG:  The child accident repeater . Clin Pediatr 1980;;19:284-288.
29 +
Mellinger GD, Manheimer DI:  An exposurecoping model of accident liability among children . J Health Soc Behavior 1967;;8:96-106.
30 +
Matheny AP:  Visual-perceptual exploration and accident liability in children . J Pediatric Psychol 1980;;5:343-351.
31 +
Husband P, Hinton PE:  Families of children with repeated accidents . Arch Dis Child 1972;; 47:396-400.
32 +
Sims ACP:  Head injury, neurosis and accident proneness . Adv Psychosom Med 1985;;13: 49-70.
33 +
McCormick MC, Shapiro S, Starfield BH:  Injury and its correlates among 1-year-old children . AJDC 1981;;135:159-163.
34 +
Boyce WT, Sobolewski S, Sprunger LW, et al:  Playground equipment injuries in a large, urban school district . Am J Public Health 1984;;74: 984-986.
35 +
Reason J:  Style, personality and accidents . New Society 1974;;27:445-448.
36 +
Meyer RJ, Roelofs HA, Bluestone J, et al:  Accidental injury to the preschool child . J Pediatrics 1963;;63:95-105.
37 +
Schor EL:  Unintentional injuries: Patterns within families . AJDC 1987;;141:1280-1284.
38 +
Horwitz SM, Morgenstern H, DiPietro L, et al:  Determinants of pediatric injuries . AJDC 1988;;142:605-611.
39 +
Padilla ER, Rohsenow DJ, Bergman AB:  Predicting accident frequency in children . Pediatrics 1976;;58:223-226.
40 +
Wallack L, Winkleby M:  Primary prevention: A new look at basic concepts . Soc Sci Med 1987;;25:923-930.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
World Health Organization:  Health of the world's children . WHO Chron 1979;;33:119-127.
2 +
Baker SP, O'Neill B, Karg R: The Injury Fact Book . Lexington, Ky, DC Heath & Co, 1984;.
3 +
Guyer B, Gallagher S:  An approach to the epidemiology of childhood injuries . Pediatr Clin North Am 1985;;32:5-15.
4 +
Vital and Health Statistics: Current Estimates from the National Health Interview Survey , Department of Health and Human Services publication 82-1567, Hyattsville, Md, National Center for Health Statistics, 1981;.
5 +
Rivara FP, Bergman AB, LoGerfo JP, et al:  Epidemiology of childhood injuries: Sex differences in injury rates . AJDC 1982;;136:502-506.
6 +
Rivara FP:  Epidemiology of childhood injuries: I. Review of current research and presentation of conceptual framework . AJDC 1982;;136: 399-405.
7 +
Baker SP:  Determinants of injury and opportunities for intervention . Am J Epidemiol 1975;;101:98-102.
8 +
Pless IB, Stulginskas J:  Accidents and violence as a cause of morbidity and mortality in childhood . Adv Pediatr 1982;;29:471-495.
9 +
Boyce WT, Sprunger LW, Sobolewski S, et al:  Epidemiology of injuries in a large, urban school district . Pediatrics 1984;;74:342-349.
10 +
Sheps SB, Evans GD:  Epidemiology of school injuries: A two-year experience in a municipal health department . Pediatrics 1987;;79:69-75.
11 +
Feldman W, Woodward CA, Hodgson C, et al:  Prospective study of school injuries: Incidence, types, related factors and initial management . Can Med Assoc J 1983;;129:1279-1283.
12 +
Schor EL:  Use of health care services by children and diagnoses received during presumably stressful life transitions . Pediatrics 1986;;77: 834-841.
13 +
Schinke SP, Schilling FR, Snow WH:  Stress management with adolescents at the junior high transition: An outcome evaluation of coping skills intervention . J Human Stress 1987;;13:16-22.
14 +
Chang A, Lugg MM, Nedebum A: Injuries in preschool children enrolled in day care centers. Pediatrics. In press.
15 +
Bijur PE, Stewart-Brown S, Butler N:  Child behavior and accidental injury in 11 966 preschool children . AJDC 1986;;140:487-492.
16 +
Gallagher SS, Finison K, Guyer B, et al:  The incidence of injuries among 87 000 Massachusetts children and adolescents: Results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System . Am J Public Health 1984;;74:1340-1347.
17 +
Manheimer DI, Mellinger GD:  Personality characteristics of the child accident repeater . Child Dev 1967;;38:491-513.
18 +
Froggatt P, Smiley JA:  The concept of accident proneness: A review . Br J Indust Med 1964;;21:1-12.
19 +
Connolly J:  Accident proneness . Br J Hosp Med 1981;;26:470-479.
20 +
Sass R, Crook G:  Accident proneness: Science or non-science? Int J Health Serv 1981;;11: 175-190.
21 +
Farmer E, Chambers EG: A psychological study of individual differences in accident rates . London, Industrial Fatigue Research Board, report No. (38) , 1926;.
22 +
Langley J, Silva PA, Williams S:  A study of the relationship of 90 background developmental behavioural and medical factors to childhood accidents: A report from the Dunedin Multidisciplinary Child Development Study . Aust Paediatr J 1980;;16:244-247.
23 +
Langley J:  The 'accident prone' child: The perpetration of a myth . Aust Paediatr J 1982;; 18:243-246.
24 +
Langley J, McGee R, Silva P, et al:  Child behavior and accidents . J Pediatr Psychol 1983;;8:181-189.
25 +
Langley J, Dodge J, Silva PA:  Accidents in the first five years of life: A report from the Dunedin Multidisciplinary Child Development Study . Aust Paediatr J 1979;;15:255-259.
26 +
Husband P:  The accident-prone child . Practitioner 1973;;211:335-344.
27 +
Eminson CJ, Jones H, Goldacre M:  Repetition of accidents in young children . J Epidemiol Community Health 1986;;40:170-173.
28 +
Jones JG:  The child accident repeater . Clin Pediatr 1980;;19:284-288.
29 +
Mellinger GD, Manheimer DI:  An exposurecoping model of accident liability among children . J Health Soc Behavior 1967;;8:96-106.
30 +
Matheny AP:  Visual-perceptual exploration and accident liability in children . J Pediatric Psychol 1980;;5:343-351.
31 +
Husband P, Hinton PE:  Families of children with repeated accidents . Arch Dis Child 1972;; 47:396-400.
32 +
Sims ACP:  Head injury, neurosis and accident proneness . Adv Psychosom Med 1985;;13: 49-70.
33 +
McCormick MC, Shapiro S, Starfield BH:  Injury and its correlates among 1-year-old children . AJDC 1981;;135:159-163.
34 +
Boyce WT, Sobolewski S, Sprunger LW, et al:  Playground equipment injuries in a large, urban school district . Am J Public Health 1984;;74: 984-986.
35 +
Reason J:  Style, personality and accidents . New Society 1974;;27:445-448.
36 +
Meyer RJ, Roelofs HA, Bluestone J, et al:  Accidental injury to the preschool child . J Pediatrics 1963;;63:95-105.
37 +
Schor EL:  Unintentional injuries: Patterns within families . AJDC 1987;;141:1280-1284.
38 +
Horwitz SM, Morgenstern H, DiPietro L, et al:  Determinants of pediatric injuries . AJDC 1988;;142:605-611.
39 +
Padilla ER, Rohsenow DJ, Bergman AB:  Predicting accident frequency in children . Pediatrics 1976;;58:223-226.
40 +
Wallack L, Winkleby M:  Primary prevention: A new look at basic concepts . Soc Sci Med 1987;;25:923-930.

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