Student injury rates in public schools

Adolescent school injuries and classroom sex compositions in German secondary schools

BACKGROUND

School injuries are an important adolescent health problem. Previous research suggests that relevant risk behaviors for school injuries, risk-taking and aggression, are highly susceptible to peer effects. Specifically, evidence suggests that the ratio of men and women in peer groups (sex ratio) affects individuals' propensity for aggression and risk-taking. However, potential associations of classroom sex ratios with adolescent school injury risks have not been studied so far. The purpose of this paper is to investigate the association of classroom sex compositions with adolescent school injuries.

METHODS

We investigate the association of classroom sex ratios with school injuries in a longitudinal survey dataset containing 13,131 observations from 9,204 adolescent students (ages 13-16) from secondary schools in Germany. The data also allow us to identify injuries due to aggressive behavior and analyze these injuries in detail. We use multilevel logistic regression models to analyze risks of both overall and aggression-related school injuries.

RESULTS

Adolescent students' risk for school injuries is significantly and positively associated with male-skewed classroom sex ratios (OR = 1.012, p=0.012). Specifically, the risk of sustaining a school injury increases by 33.5 percent when moving from the 10th to the 90th classroom sex ratio percentile. Moreover, we find an even stronger positive association between male-dominated classrooms and aggression-related injury risks (OR = 1.022, p=0.010). Compared to classroom sex ratios at the 10th percentile, the risk of an aggression-related injury is 78 percent higher in classrooms with a sex ratio at the 90th percentile. Finally, we find that both boys' and girls' injury risks equally increase with a higher proportion of male students in their classroom.

CONCLUSIONS

Our findings indicate that sex composition of classrooms is an important contextual factor for adolescent school injuries, in particular school injuries resulting from aggression. These findings illustrate the need to integrate a contextual perspective on school injuries among adolescent students both into research and into intervention planning.

Incidence and outcomes of school-based injuries during four academic years in Kocaeli, Turkey

BACKGROUND

School-based injuries are an important public health problem. The aim of this study was to determine the incidence as well as outcomes of school-based injuries at a public primary and secondary school.

METHODS

This retrospective cohort study involved 2956 students enrolled at a public primary and secondary school in the central district of Kocaeli province in Turkey from the academic year 2010-2011 to 2013-2014. The data were collected by intern public health nurses at school health units using a school-based injury form.

RESULTS

The total incidence of school-based injuries during 4 academic years was 10.52% person-year. The majority of the injured students were aged 10-15 years (73.3%), and boys (65%). Around one-tenth of the injuries were serious, such as burn, fracture-dislocation and soft-tissue injuries. Outdoor injuries were more prevalent for girls while boys had more indoor injuries (50.5%, 53.0%, P > 0.05). The number of the incidence of ≥two injuries increased as the academic year progressed, and there was a weak positive association between the variables (P < 0.05, Cramer's V = 0.311). One out of six injuries were intentional, with the highest incidence in the 6-9 year age group (20.5%) and boys sex (19.8%; P > 0.05).

CONCLUSIONS

School-based injuries at primary and secondary school still challenge the health as well as the security of the students. © 2016 Japan Pediatric Society.