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Kruckow S, Santini ZI, Hjarnaa L, Becker U, Andersen O, Tolstrup JS. Associations between alcohol intake and hospital contacts due to alcohol and unintentional injuries in 71,025 Danish adolescents - a prospective cohort study. EClinicalMedicine 2023; 64:102187. [PMID: 37936661 PMCID: PMC10626163 DOI: 10.1016/j.eclinm.2023.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 11/09/2023] Open
Abstract
Background Alcohol is a leading risk factor to adolescent health. However, it is unclear how associations between alcohol intake and injuries are shaped. We investigated the dose-response relationship between alcohol intake and risk of hospital contacts due to alcohol and unintentional injuries in adolescents. Methods We conducted a prospective cohort study including 71,025 Danish students aged 15-24 years, followed up for five years from 2014 to 2019. The main outcome measures were hospital contacts due to alcohol and unintentional injuries (all injuries and head injuries), obtained from hospital registers. Findings Approximately 90% of males and females reported drinking alcohol, and the median intake among those was 11 drinks/week in males and 8 drinks/week in females. During five years of follow-up, 1.3% had an alcohol-attributable hospital contact, the majority of which were due to acute intoxication (70%). Alcohol-attributable hospital contacts were equally frequent in males and females and between age groups (15-17-year-olds vs 18-24-year-olds). Compared with never drinking, the adjusted incidence rate ratios for weekly intake of <7, 7-13, 14-20, 21-27, and >27 drinks/week were 1.70 (95% confidence interval 1.23-2.34), 1.77 (1.27-2.46), 1.91 (1.35-2.70), 2.34 (1.59-3.46), and 3.25 (2.27-4.64) for having an alcohol-attributable hospital contact within five years of follow-up. Restricting follow-up to one year more than doubled risk estimates. During the five years of follow-up, 27% incurred an unintentional injury. The most frequent types of injury were to the wrist or hand (27.6%), ankle or foot (25.2%), or head (12.4%). Injuries were more frequent among males (first-time incidence rate 110 per 1000 person-years) compared to females (82 per 1000 person-years), with no differences between age groups. Compared with never drinking, the adjusted incidence rate ratios for weekly intake of <7, 7-13, 14-20, 21-27, and >27 drinks were 1.09 (1.03-1.15), 1.14 (1.07-1.20), 1.25 (1.17-1.33), 1.38 (1.28-1.49), and 1.58 (1.47-1.69) for having a hospital contact for any type of unintentional injury within five years of follow-up. Results for the one-year follow-up period were comparable. Separate analysis for head injuries showed similar results as the analysis on all injuries. Results were generally similar in males and females. Interpretation Adolescents' drinking is associated with a higher risk of acute harm in terms of hospital contacts due to alcohol and unintentional injuries in a dose-response relationship. Thus, increased risk was apparent in those with low alcohol intake, suggesting a need for awareness of and initiatives to prevent youth drinking. Furthermore, initiatives should include a strengthened focus on people younger than 18 years. Funding This study was funded by the Tryg Foundation (ID: 153539) and The Helse Foundation (21-B-0359).
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Affiliation(s)
- Sofie Kruckow
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ziggi Ivan Santini
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Louise Hjarnaa
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Janne S. Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Wang Z, Chen H, Yu T, Liu S, Hu M. Status of injuries as a public health burden among children and adolescents in China: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17671. [PMID: 31702619 PMCID: PMC6855559 DOI: 10.1097/md.0000000000017671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Ziyu Wang
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha
| | - Hui Chen
- Department of Medicine, Betta Pharmaceuticals Co., Ltd., Hangzhou
| | - Taolin Yu
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha
| | - Siyun Liu
- Department of Medical Records, Chongqing General Hospital, Chongqing, China
| | - Ming Hu
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha
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Jiang H, Xiang X, Hao W, Room R, Zhang X, Wang X. Measuring and preventing alcohol use and related harm among young people in Asian countries: a thematic review. Glob Health Res Policy 2018; 3:14. [PMID: 29761160 PMCID: PMC5941657 DOI: 10.1186/s41256-018-0070-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 03/28/2018] [Indexed: 11/15/2022] Open
Abstract
Background The paper reviews alcohol consumption patterns and alcohol-related social and health issues among 15–29-year old young people in Asian countries, and discusses strategies for preventing and controlling alcohol use and related harms. Methods We searched Google Scholar, PubMed, and Web of Science for reports, reviews and journal articles published in English between 1st Jan 1990 and 31st August 2016. Results Forty-one reports, reviews and journal papers were identified and included in the final review. The current drinking levels and prevalence among young people are markedly different between eight included Asian countries, ranging from 4.2% in Malaysia to 49.3% in China. In a majority of the selected Asian countries, over 15% of total deaths among young men and 6% among young women aged 15–29 years are attributable to alcohol use. Alcohol use among young people is associated with a number of harms, including stress, family violence, injuries, suicide, and sexual and other risky behaviours. Alcohol policies, such as controlling sales, social supply and marketing, setting up/raising a legal drinking age, adding health warning labels on alcohol containers, and developing a surveillance system to monitor drinking pattern and risky drinking behaviour, could be potential means to reduce harmful use of alcohol and related harm among young people in Asia. Conclusions The review reveals that drinking patterns and behaviours vary across eight selected Asian countries due to culture, policies and regional variations. The research evidence holds substantial policy implications for harm reduction on alcohol drinking among young people in Asian countries -- especially for China, which has almost no alcohol control policies at present.
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Affiliation(s)
- Heng Jiang
- 1Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086 Australia.,2Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC 3000 Australia
| | - Xiaojun Xiang
- 3Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, 410011 Hunan China
| | - Wei Hao
- 3Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, 410011 Hunan China
| | - Robin Room
- 1Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086 Australia.,4Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-106 91 Stockholm, Sweden
| | - Xiaojie Zhang
- 3Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, 410011 Hunan China
| | - Xuyi Wang
- 3Mental Health Institute of the Second Xiangya Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, 410011 Hunan China
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Chen Y, Gao Y, Zhou L, Tan Y, Li L. A Comparative Study of Dog- and Cat-Induced Injury on Incidence and Risk Factors among Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111079. [PMID: 27827898 PMCID: PMC5129289 DOI: 10.3390/ijerph13111079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 02/05/2023]
Abstract
Background: Millions of people are bitten by animals each year, with approximately 90% of the injuries being caused by dogs and cats. However, few studies focus on risk factors of dog- and cat-induced injury in China. Therefore, the objective of this study was to investigate the rate of dog- and cat-induced injury and its potential risk factors. Methods: The data were from a population-based cross-sectional study conducted in 2015, with a sample of 9380 children 6-19 years of age from two cities, Shenzhen (large city) and Shantou (mid-sized city), in southern China. Multivariate logistic regression models were used to identify the risk factors of injury by dogs and cats. Results: The total rates of dog and cat-induced injury were 15.1% and 8.7% during the lifetime, and 3.4% and 1.7% during the past year, respectively. Dog bites mostly occurred in the dog's residence (49.4%). Cat scratches were more likely to be inflicted by one's own cat (47.5%). Children living in suburban and island county had 2.83 times and 2.53 times more dog-related injuries than central urban children, respectively. After stratification by cities, injuries in Shantou were correlated with non-single child families (OR (odds ratios), 1.46; 95% CI (95% confidence interval), 1.09-1.96) and raising cats (OR, 5.34; 95% CI, 3.88-7.35). Those who disliked animals (OR, 0.62; 95% CI, 0.45-0.88) or had good academic performance (OR, 0.46; 95% CI, 0.35-0.60) had lower risk for injury. Injuries in Shenzhen were related to the mother's educational level (OR, 1.51; 95% CI, 1.11-2.07) and mother being a migrant worker (OR, 2.10; 95% CI, 1.12-3.94). Conclusions: Family factors were important to predict dog- and cat-induced injury among children from Shenzhen, and personal factors were closely associated with injury among children form Shantou.
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Affiliation(s)
- Ying Chen
- Center for Injury Prevention Research, Shantou University Medical College, Shantou 515041, China.
| | - Yang Gao
- Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China.
| | - Li Zhou
- Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China.
| | - Yafei Tan
- Center for Injury Prevention Research, Shantou University Medical College, Shantou 515041, China.
| | - Liping Li
- Center for Injury Prevention Research, Shantou University Medical College, Shantou 515041, China.
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Santagati G, Vezzosi L, Angelillo IF. Unintentional Injuries in Children Up to Six Years of Age and Related Parental Knowledge, Attitudes, and Behaviors in Italy. J Pediatr 2016; 177:267-272.e2. [PMID: 27492869 DOI: 10.1016/j.jpeds.2016.06.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
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.
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Affiliation(s)
- Gabriella Santagati
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Luigi Vezzosi
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Italo F Angelillo
- Department of Experimental Medicine, Second University of Naples, Naples, Italy.
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ALBashtawy M, Al-Awamreh K, Gharaibeh H, Al-Kloub M, Batiha AM, Alhalaiqa F, Hamadneh S. Epidemiology of Nonfatal Injuries Among Schoolchildren. J Sch Nurs 2016; 32:329-36. [PMID: 27255142 DOI: 10.1177/1059840516650727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
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.
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Affiliation(s)
- Mohammed ALBashtawy
- Community and Mental Health Department, Princess Salma Faculty of Nursing, AL al-Bayt University, Mafraq, Jordan
| | - Khetam Al-Awamreh
- Department of Maternal and Child Health Nursing, Princess Salma Faculty of Nursing, AL al-Bayt University, Mafraq, Jordan
| | | | - Manal Al-Kloub
- Maternal, Child and Family Health Department, The Hashemite University, Zarqa, Jordan
| | | | | | - Shereen Hamadneh
- Department of Maternal and Child Health Nursing, Princess Salma Faculty of Nursing, AL al-Bayt University, Mafraq, Jordan
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Nmor JC, Nwaka KH, Goto K, Toyosawa J, Fujita D. High rate of injuries among students in Southern Nigeria: An urgent call to action. Health (London) 2013. [DOI: 10.4236/health.2013.512266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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