Status and risk factors of unintentional injuries among Chinese undergraduates: a cross-sectional study

Approaching the Causes of Unintentional Injuries in the School Environment: A Panel Analysis of Survey Data From Germany

BACKGROUND

Previous research on the correlates of unintentional school injuries is based on either process or cross-sectional data. This study aims at approaching the causal effects of risk-seeking behavior, mental health problems, physical activity, and exposure to bullying on unintentional injuries in the school environment by relying on longitudinal survey data.

METHODS

The data comes from a German panel survey, including more than 10,000 students. We estimate fixed-effects regression models that only take into account the variation within participants and are therefore most suitable for establishing causal inferences.

RESULTS

We find an increase in risk-seeking behavior on the individual level to yield an increase in students' likelihood to suffer injuries during physical education and on the schoolyard or in the school building. The same holds true for an increase in mental health problems. Finally, students who expand their degree of physical activity in club sports also show a higher risk of unintentional injuries.

CONCLUSIONS

Interventions aimed at reducing too risky behavior and mental health problems may help prevent unintentional injuries in the school environment. Since students who increase their activities in club sports are also more prone to school injuries, preventive efforts should include this group of adolescents as well.

Unintentional injury and its determinants among adolescents

Background: Globally, unintentional injury has been a documented public health problem among adolescents having debilitating consequences and accountable for economic burden. The study was undertaken to estimate the prevalence of unintentional injury, identify the determinants and consequences among adolescents.

Design and Methods: This cross-sectional study recruited 222 adolescents using systematic random sampling from a site covered under UHTC Srinagar Garhwal, Uttarkhand. Binary and multivariate logistic regression was used to compute crude and adjusted odds ratio (95% CI) for establishing an association between risk factors and unintentional injury. Descriptive measures (causes, consequences, etc.) describing injuries were presented in tabular, graphical form in proportions.

Results: 73.1% of the adolescents suffered from unintentional injury. The risk factors associated (statistically insignificant) with unintentional injury was males (AOR=1.019, 95% CI=0.524-1.979), living in nuclear family (AOR=1.540, 95% C =0.766-3.093), smoked tobacco (AO=2.797, 95% CI=0.227-34.4377), visually impaired (AOR=1.629 95% CI=0.548-6.458) and living in house with overcrowding (AOR =1.66, 95% CI=0.818-3.395). Five percent of those affected with unintentional injury had disability.% of those affected with unintentional injury had disability.

Conclusions: Health education addressing causes, risk factors, consequences of unintentional injury among adolescents, parents, school, and district health authorities should be mandated for the formulation of policy to prevent unintentional injuries.

Status of injuries as a public health burden among children and adolescents in China: A systematic review and meta-analysis

INTRODUCTION

Injuries among children and adolescents remain a major public health problem in China. In the present study, we undertook a systematic review and meta-analysis of the published literature of epidemiological studies investigating injuries among children and adolescents in China and aimed to describe the status of injury among children and adolescents (aged 0-19 years) in China nationwide. A random-effects meta-analysis model was used to calculate the pooled prevalence of injury with 95% confidence intervals (CIs) across studies. The potential heterogeneity moderators were identified by subgroup and sensitivity analysis. A total of 775,615 children and adolescents were included in this study. Overall, the pooled injury prevalence among children and adolescents aged 0 to 19 years was 23.0% (95% CI 20.0%-27.0%) in studies using 1996 version of injury definition, and 13.0% (95% CI 10.0%-17.0%) in studies using 2004 version of injury definition. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results.

CONCLUSION

Our study shows a moderately high injury prevalence among children and adolescents aged 0 to 19 years in China, more prevention policies and programs should be urgently developed to decrease the occurrence of child and adolescent injury.

Unintentional Injuries in Children Up to Six Years of Age and Related Parental Knowledge, Attitudes, and Behaviors in Italy

OBJECTIVES

To describe risk factors associated with unintentional injuries among children aged <6 years and to examine parents' level of knowledge, attitudes, and behaviors about pediatric injuries and related preventive measures.

STUDY DESIGN

A cross-sectional survey was conducted between May and July 2015 on a random sample of 794 parents of 3- to 6-year-old children through a self-administered anonymous questionnaire.

RESULTS

A total of 409 parents participated. Two-thirds of the children had experienced at least 1 unintentional injury in the previous 12 months. More than one-half of these children were boys. The leading cause was falls; the injuries occurred mainly at home, and only 9.2% were brought for attention to an emergency department. Parents who did not believe that it is possible to prevent unintentional injuries were more likely to have had a child injured. Approximately 70% of respondents were aware of security measures to prevent pediatric injuries, and this knowledge was more prevalent in older parents and in those with at least a college level of education compared with those with a middle school education. The perceived utility of education about preventive measures of pediatric injuries had a mean value of 8.9 on a Likert scale of 1-10 (1, not useful, to 10, very useful) and was significantly higher in mothers.

CONCLUSIONS

This study highlights a clear need for public health educational programs for parents regarding prevention of unintentional injuries in children as a valuable tool to increase safety and injury prevention and to reduce risks, because the majority of such injuries occur at home.

Epidemiology of Nonfatal Injuries Among Schoolchildren

Nonfatal injuries are considered as one of the major public health hazards affecting schoolchildren, and the majority of these injuries occur at school or in the home. A cross-sectional study was conducted over a period of 3 months, March-May 2015. The participants were 4,355 Jordanian schoolchildren in Grades 7-12. The Pearson χ(2) test was computed, and the odds ratio was used to determine the magnitude of various risk factors for nonfatal injuries among schoolchildren. The overall incidence of nonfatal injury was 33.9%. The group most likely to sustain nonfatal injuries was boys, aged 12-15, in Grade 7, whose parents had a low level of education or a high family income. Injury prevention in schools and at homes is a cornerstone for protection or reducing the incidence of injuries. School nurses have a duty to follow up and examine the accident reports and evaluate whether safety policies are applied and are effective in different school settings. Furthermore, health and education authorities should develop a national program for preventing injuries.

Factors Associated with Unintentional Injury among University Students in 26 Countries

OBJECTIVE

The aim of this study was to determine estimates of the incidence and social correlates of nonfatal injury among university students in 26 low-, middle-, and high-income countries.

DESIGN AND SAMPLE

Using anonymous questionnaires, data were collected in a cross-sectional survey of 19,111 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa, and the Americas.

MEASURES

Questionnaire on health risk behaviors, psychological distress, personality, social variables, and injury requiring medical treatment or missing at least one day of usual activities.

RESULTS

The percentage of university students reporting one or more serious injuries within the past 12 months was 25.2% for all countries, in men 28.8% and women 21.1%. In multivariate logistic regression among men, socio-demographic variables, health risk behaviors, posttraumatic stress (PTSD) symptoms, lack of personal control and lack of social support, and among women, residing on campus, health risk behaviors, PTSD symptoms, lack of personal control, and lack of social support were associated with injury incidence.

CONCLUSIONS

Several risk factors were identified which will increase the understanding of public health nurses of injuries in university communities to design programs for injury prevention programs specifically targeting university students, staff, and university health center professionals.

Features and risk factors of nonfatal injury among the rural children: a survey of seven schools in a mountain area in Southwest China

Objective

We aimed to investigate the patterns and risk factors of nonfatal injuries among rural mountain-area children in southwest China.

Methods

A stratified sampling method was used to recruit rural children aged 8 to 17 years (mainly 9–14 years) from 7 schools. Self-reported injuries during the past 12 months and relevant concerns were collected from June to December 2012 by using a structured questionnaire in a class interview.

Results

The mean age of the 2,854 children was 12.2±1.5 years. The probability of annual injury was 16.7% (95% confidence interval [95% CI] 15.3–18.1%), with slightly higher injury risk for boys than girls (17.7% vs. 16.0%; P>0.05). The top 3 causes of injuries were falls (37.3%), animal-related incidents (20.6%), and burns (14.9%). The main injury risk factors included being involved in a violent episode (odds ratio [OR] 1.34, 95% CI 1.08–1.66, P = 0.007), maltreatment by parents or guardians (1.42, 1.17–1.72, P<0.001), and being from a single-child family (1.30, 1.10–1.66, P = 0.039). Older age was a protective factor (0.81, 0.76–0.87, P<0.001).

Conclusions

The incidence of nonfatal injury among rural children was high, and falls were the leading cause. Younger children and boys from poor-care and poor-living environments were at increased risk of injury, which requires urgent attention. Injury prevention programs targeting these issues are needed in this mountain area and similar rural regions of China.

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

Background

Associations 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.

Methods

On 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.

Results

A 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.

Conclusions

Both 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.

Characteristics and related factors of nonfatal injuries among adolescents and college students in Shenzhen City of China

Background

Injuries impact adolescents and young adults in unique ways. The purpose of this study was to determine the incidence rate of nonfatal injuries, and identify characteristics and risk factors for the injuries among adolescents and college students in Shenzhen, China.

Methods

A total of 4,138 students from 79 classes were selected using a purposive sampling method in 2010. The questionnaire included personal demographics, behavioral factors, and self-perceived agrypnia. Stepwise multivariate logistic regression models were used to explore the risk factors of injury.

Results

The annual incidence rate of nonfatal injuries was 13.5%. Injuries were significantly correlated with gender (boys vs. girls, adjusted odds ratio [OR], 1.58, 95% confidence interval [CI], 1.30-1.93) and self-perceived agrypnia (sometimes vs. no, adjusted OR, 1.64, 95% CI, 1.31-2.05; often vs. no, adjusted OR, 2.34, 95% CI, 1.74-3.14), attending PE class ( >2 classes/week vs. ≤ 2 classes/week, adjusted OR, 1.25, 95% CI, 1.04-1.51), sexual behaviors (yes vs. no, adjusted OR, 1.46, 95% CI, 1.03-2.07), physical fighting (yes vs. no, adjusted OR, 1.84, 95% CI, 1.49-2.28), alcohol consumption (yes vs. no, adjusted OR, 1.29, 95% CI, 1.06-1.59), unsafe cycling (yes vs. no, adjusted OR, 1.47, 95% CI, 1.20-1.80) and skating in unsafe places (yes vs. no, adjusted OR, 1.57, 95% CI, 1.10-2.24). Additionally, falls were the leading cause of injuries, and gymnasiums of schools were the most-reported places where injuries occurred.

Conclusions

Nonfatal injuries have turned into a pressing public health problem among adolescents and college students in Shenzhen, China. Strategies targeting the risk factors may be effective for the prevention of injuries.

Unintentional Injuries among School-Aged Children in Palestine: Findings from the National Study of Palestinian Schoolchildren (HBSC-WBG2006)

Purpose. This study describes the nonfatal injuries among adolescents in Palestine. Methods. The 2006 Palestinian Health Behaviour in School-aged Children (HBSC) is a cross-sectional survey. Students of grades 6, 8, 10, and 12 completed a modified version of the international HBSC questionnaire, resulting in 15,963 students (47.3% boys and 52.7% girls) included in this study (56.9% from the West Bank and 43.1% from Gaza). Results. Of the total 15,963 adolescents, 47.6% were injured, with boys (53.5%) being statistically higher than girls (42.1%) (P<0.001). The prevalence of those injured more than once decreased by age and was also found significantly higher in boys than in girls (27.3% and 17.9%, resp.) (P<0.001). Children living in low FAS families showed significantly lower ratios of injuries than those living in moderate and high FAS families (P<0.001). Injuries while biking were significantly higher among boys (46.3%) than girls (41.7%) (P<0.001), and injuries while walking/running were more prevalent among girls (32.5%) than boys (28.0%) (P<0.001). Conclusion. Despite these considerably high rates, injury remains relatively underappreciated. Results of this study are useful to develop a national injury prevention program aimed at enhancing the safety of Palestinian adolescents.