Incidence and distribution of injury among schoolchildren aged 11-15

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.

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.

Injury and social correlates among in-school adolescents in four Southeast Asian countries

The aim of this study was to determine estimates of the prevalence and social correlates of injury among adolescents in four Southeast Asian countries. Cross-sectional national data from the Global School-based Health Survey (GSHS) included 9,333 students at the ages from 13 to 15 years inclusive from Indonesia, Myanmar, Sri Lanka and Thailand is chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The percentage of adolescents reporting one or more serious injuries within the past 12 months was 42.2% for all countries, ranging from 27.0% in Myanmar to 46.8% in Thailand. By major activity, “fall” (14.6%) was the leading external cause of injury, followed by playing or training for a sport (9.9%) and vehicle accident (6.1%). In multivariate regression analysis Thailand and Indonesia, being male, substance use (smoking and drinking alcohol) and psychological distress were associated with annual injury prevalence. Risk factors of substance use and psychological distress should be considered in an integrated approach to injury etiology in planning injury prevention and safety promotion activities among school children.

Injury risk in young psychiatric outpatients: an 11-year follow-up of 302 adolescents

BACKGROUND

Studies investigating the association between injuries and mental health have mainly focused on mental health sequelae of injuries. The aim of this prospective cohort study was to assess the incidence and risk factors of physical injury hospitalisation and poisoning hospitalisation among adolescent psychiatric outpatients.

SUBJECTS AND METHODS

Data on 302 consecutively referred Finnish psychiatric outpatients aged 12-22 years (mean 16) were collected at treatment entry. The end-point of the average 11-year follow-up was death or end of follow-up on 31 December 2005. The main outcome variables were physical injury hospitalisation and poisoning hospitalisation.

RESULTS

Altogether 111 physical injury hospitalisations occurred in 65 (22% of all) persons during follow-up, incidence being 27.9 (95% CI: 22.7-33.1) per 1,000 person-years. Poisoning hospitalisation occurred in 22 (7.3%) persons, altogether 50 times, incidence being 12.6 (95% CI: 9.1-16.0). Seven injury-related deaths occurred, incidence being 1.8 (95% CI: 0.5-3.1) per 1,000 person-years. The most common physical injury types were fractures (40%), followed by distortions (10%) and wounds (10%), while poisoning for drugs accounted for 72% of the poisonings. Previous inpatient care, psychotropic medication, suicidality, and major depression were associated with poisoning hospitalisation during the follow-up while only gender was associated with physical injury hospitalisation.

CONCLUSION

Injuries cause significant morbidity among psychiatric outpatients, but only poisonings seem to be related with suicidality in Finnish adolescent psychiatric outpatients. The high frequency of injuries seems to justify clinicians' attention to these aspects when assessing the need for care among young people.

Alcohol consumption and injury among Canadian adolescents: variations by urban-rural geographic status

CONTEXT

The impact of alcohol consumption on risks for injury among rural adolescents is an important and understudied public health issue. Little is known about whether relationships between alcohol consumption and injury vary between rural and urban adolescents.

PURPOSE

To examine associations between alcohol and medically attended injuries by urban-rural geographic status using a representative national sample of Canadian adolescents.

METHODS

The study involved a secondary analysis of a national sample of Canadian adolescents aged 11-15 years (n = 7,031) from the 2001-2002 Health Behavior in School-Aged Children Survey. Respondents were classified into 5 geographic categories of rural-urban status. Multiple logistic regression was used to examine the magnitude and homogeneity of associations between drinking patterns and adolescent injuries across these 5 geographic groupings.

FINDINGS

Higher rates of alcohol consumption and adolescent injuries were observed in more rural areas. Alcohol consumption was significantly associated with higher risks for injury occurrence with evidence of a dose-related pattern of risk. Associations between alcohol consumption and injury were consistent by urban-rural geographic status.

CONCLUSIONS

Misuse of alcohol is an important potential cause of injury. Adolescents whose lifestyle includes alcohol consumption experience higher risks for injury, and this association is observed consistently by urban-rural geographic status. Findings of this study emphasize a need to intervene with high-risk adolescents as a tertiary prevention strategy, irrespective of geographic background.

Trauma and Adult Attention Deficit Hyperactivity Disorder

This study investigated the relationship between adult attention deficit hyperactivity disorder (ADHD) and trauma. Fifty-eight adults admitted to hospital with musculoskeletal trauma were evaluated using scales that determine the presence of ADHD in childhood and adulthood. Each patient was also interviewed by an adult psychiatrist and a child and adolescent psychiatrist. The control group consisted of 30 adult patients with complaints other than trauma who did not have a history of repetitive traumas. There were 36 (62.2%) cases of ADHD in the patient group compared with four (13.3%) in the control group; this difference was statistically significant. When the level of trauma was evaluated, ADHD was identified in 23 of the 26 (88.5%) patients with high energy traumas compared with 14 of the 32 (43.8%) patients with low energy traumas; this difference was also statistically significant. This study shows that patients with adult ADHD are more prone to injuries, particularly high energy traumas such as motor vehicle accidents. Patients who have repeated high energy traumas should be evaluated by a psychiatrist for ADHD.

Acidentes não fatais em adolescentes escolares de Belém, Pará

OBJETIVO: Verificar a ocorrência de acidentes não fatais em adolescentes escolares do município de Belém, Pará. MÉTODOS: Estudo transversal. Amostra probabilística por conglomerados obtida em múltiplos estágios, que incluiu 2.828 adolescentes escolares, com idades entre 17 e 18 anos, matriculados na terceira série do ensino médio de escolas públicas e privadas de Belém, no ano 2000. Coleta de dados: questionário semi-estruturado de autopreenchimento. Análise estatística: comparação das variáveis categóricas por teste do qui-quadrado, calculado pelo programa Epitable, do Epi-Info 6.01. RESULTADOS: A média de idade dos escolares foi 17,7 anos, sendo 60% meninas, 82% estudavam na rede pública, 61% residiam com pai e mãe e 23% com apenas um dos genitores. A ocorrência de pelo menos um acidente foi relatada por 1.987 (70%) adolescentes. Os mais freqüentes foram: quedas (35%), contato com vidro, faca, espada e punhal (30%), contato com fonte de calor ou substâncias quentes (22%), acidentes de transporte (20%) e mordeduras por cão ou outros mamíferos (18%). A ocorrência foi maior no sexo masculino (78%) do que no feminino (65%) e entre estudantes da rede privada (77%) em comparação aos da rede pública (69%). Um terço dos acidentes levou os adolescentes à procura do serviço de saúde e, destes, 9% foram hospitalizados. CONCLUSÕES: Verificou-se elevada ocorrência de acidentes em adolescentes escolares, confirmando a vulnerabilidade desta faixa etária. Concluiu-se que a melhor condição social, aqui representada pela procedência da escola privada, não conferiu proteção a esses escolares.

An association between socioeconomic, health and health behavioural indicators and fractures in young adult males

The aim of this survey study with 7,083 male respondents was to examine the association between socioeconomic, health and health behavioural risk indicators and fractures. In the multivariate regression model, fractures were associated strongest with frequency of drunkenness, regular sports training, frequent use of health care services and obesity.

INTRODUCTION

Little is known about the risk factors for fractures in young adults. Our aim was to identify the association between socioeconomic background, health and health behaviours and fractures.

METHODS

The survey sample comprised 7,378 conscript males (median age 19), of which 7,083 (96%) answered. The outcome was self-reported fracture. Associations between 20 background variables and fractures were analysed with logistic regression.

RESULTS

Altogether 2,456 (34.7%) participants reported fracture(s) during their lifetime. The most common anatomical locations of fracture were the forearm, the hand and the ankle. The strongest risk indicators for fractures were frequent drunkenness (OR 1.7; 95% CI: 1.3-2.0), regular sports training (OR 1.6; 95% CI: 1.3-1.9), frequent use of health care services (OR 1.5; 95% CI: 1.3-1.8) and obesity (OR 1.5; 95% CI: 1.2-1.9).

CONCLUSIONS

This is among the first studies to describe risk indicators for fractures in young adults. The strongest risk factors for fractures were associated with health damaging behaviour, high-intensity physical activity and use of health care services. Of socioeconomic background factors, only living in the capital city area was associated with fractures. Preventive measures should be targeted at the males frequently using health care services or actively participating in sports.

Relationship between mechanisms and activities at the time of pedestrian injury and activity limitation among school adolescents in Kathmandu, Nepal

This study assessed the relationship between pedestrian activity at the time of injury, the type of vehicle involved and resulting activity limitation among school adolescents in the Kathmandu and Lalitpur districts of Nepal. A cross-sectional study of 1557 students in grades 6-8 across 14 schools was conducted using a self-administered questionnaire from August to September 2003. Twenty-three percent of adolescents reported pedestrian injuries, 38% were from urban and 21% from semi-urban areas. Adolescents were commonly injured by motorcycles and motor vehicles while crossing the road; however, while walking and playing, they were commonly injured by bicycles and motorcycles. Bicycles and motor vehicles were less likely to be involved in injury while crossing the roads and playing, respectively (p < 0.001). Activity was more likely to be limited for a longer period of time (> 7 days) with injuries endured while crossing the road (p < 0.001). In urban areas, boys and girls were more likely to be injured while crossing the road and walking, respectively (p < 0.05), and both were commonly injured by motorcycles. In semi-urban areas, boys and girls were commonly injured while walking and were more likely to be injured by motorcycles and bicycles, respectively (p < 0.05). In both areas, more boys than girls were injured while playing. These findings have important implications for pedestrian safety interventions in poor countries.

Unintentional injuries among school adolescents in Kathmandu, Nepal: A descriptive study

OBJECTIVE

To describe detailed mechanisms and activities at the time of unintentional injuries among adolescents in Kathmandu, Nepal.

METHODS

A school-based study was conducted on 1557 students in grades 6-8 across 14 schools, using a self-administered questionnaire during August-September 2003. Mechanisms and activities were coded using the Nordic Medico Statistical Committee's classification.

FINDINGS

Falls (65%) and cuts (63%) were the most common injuries, followed by transport-related injuries (36%) and burns (22%). In urban areas, falls (59%) were the most common injuries, followed by transport-related injuries (50%); in semi-urban areas, falls (66%) and cuts (65%) were the most common injuries, followed by transport-related injuries (34%). At the time of falls, boys were generally engaged in sports while girls were engaged in walking on streets or on stairs in houses, in both areas. Falls from trees among boys and falls from roofs among girls were also common in semi-urban areas. Cut injuries while processing food were common among boys and girls in both areas, whereas agricultural work was also a source of injury in semi-urban areas. Pedestrian injuries were common during transport among boys and girls in both areas; boys in semi-urban areas were almost equally likely to be injured during cycling. Burn injuries while cooking and serving food were more common among girls in semi-urban areas.

CONCLUSION

Falls, cuts, transport-related injuries, and burn injuries were quite prevalent among adolescents in Kathmandu. The reported injury mechanisms and activities posing injury risks have implications for future interventions.

Distinguishing inflicted versus accidental abdominal injuries in young children

OBJECTIVES

To compare the presentation of young children with abdominal trauma caused by high-velocity accidental (HVA), low-velocity accidental (LVA), and inflicted injury, and to test the hypothesis that a delay in care is highly predictive of an inflicted injury.

METHODS

We performed a retrospective chart review at an urban Level I pediatric trauma center between 1991 and 2001 of children younger than 6 years who were admitted with abdominal injuries and an Abbreviated Injury Scale (AIS) score > or = 2. Charts were abstracted for demographic information, history of presentation, mechanism of injury, and diagnoses. Accidental injuries were defined as high velocity (motor vehicle crash or a fall from > 10 feet) or low velocity (household trauma, bicycle crash, or a fall from < 10 feet). Inflicted trauma was defined as a constellation of unexplained injuries, confessions by a perpetrator, or disclosure by the victim.

RESULTS

Of the 121 children in the study, 77 (64%) had HVA injuries, 31 (26%) had LVA injuries, and 13 (11%) had inflicted injuries. Solid organ injuries (e.g., liver, spleen, and kidney) were most common in all groups, and abused children were significantly more likely to have suffered a hollow viscus injury (p = 0.03). Abused children were also significantly more likely to have suffered injuries with an AIS score >3 and combined hollow viscus and solid organ injuries than the HVA group or the LVA group (p < 0.001). Presentation for medical care occurred within 12 hours for 100% of the HVA group but only 65% of the LVA group, and 46% of the abuse group (p < 0.001). Presentation to care at greater than 12 hours was neither specific nor highly predictive of abuse, as some children with LVA injuries presented for care late despite developing symptoms shortly after their injury occurred (specificity, 65% [95% confidence interval, 45-81%]; positive predictive value, 39% [95% confidence interval, 17-64%]).

CONCLUSION

Young children with inflicted abdominal injuries are more likely to have more severe injuries, multiple injuries, and a delay in seeking care than young children with accidental abdominal trauma. However, delay in seeking care is not specific for inflicted injury and occurs in some children with LVA abdominal trauma.

Cross-national study of fighting and weapon carrying as determinants of adolescent injury

OBJECTIVES

We sought to (1) compare estimates of the prevalence of fighting and weapon carrying among adolescent boys and girls in North American and European countries and (2) assess in adolescents from a subgroup of these countries comparative rates of weapon carrying and characteristics of fighting and injury outcomes, with a determination of the association between these indicators of violence and the occurrence of medically treated injury.

DESIGN AND SETTING

Cross-sectional self-report surveys using 120 questions were obtained from nationally representative samples of 161082 students in 35 countries. In addition, optional factors were assessed within individual countries: characteristics of fighting (9 countries); characteristics of weapon carrying (7 countries); and medically treated injury (8 countries).

PARTICIPANTS

Participants included all consenting students in sampled classrooms (average age: 11-15 years).

MEASURES

The primary measures assessed included involvement in physical fights and the types of people involved; frequency and types of weapon carrying; and frequency and types of medically treated injury.

RESULTS

Involvement in fighting varied across countries, ranging from 37% to 69% of the boys and 13% to 32% of the girls. Adolescents most often reported fighting with friends or relatives. Among adolescents reporting fights, fighting with total strangers varied from 16% to 53% of the boys and 5% to 16% of the girls. Involvement in weapon carrying ranged from 10% to 21% of the boys and 2% to 5% of the girls. Among youth reporting weapon carrying, those carrying handguns or other firearms ranged from 7% to 22% of the boys and 3% to 11% of the girls. In nearly all reporting countries, both physical fighting and weapon carrying were significantly associated with elevated risks for medically treated, multiple, and hospitalized injury events.

CONCLUSIONS

Fighting and weapon carrying are 2 common indicators of physical violence that are experienced by young people. Associations of fighting and weapon carrying with injury-related health outcomes are remarkably similar across countries. Violence is an important issue affecting the health of adolescents internationally.

The NICE guidelines in the real world: a practical perspective

This review examines the derivation of the NICE guidelines and discusses some of the problems of putting research into practice.

Is obesity associated with injuries among young people?

OBJECTIVES

To look at the relationship between obesity and trauma among young people in the Hainaut Province in Belgium.

DESIGN

A cross-sectional study (questionnaire and physical examination) was conduced among a sample of 2363 children of 9- to 17-year-olds (n = 2363) in 1998.

RESULTS

In the past 12 months prior to the survey, 37% of the sample had at least one injury requiring treatment (with or without hospitalization), and 5% had a severe injury (with at least one night at the hospital). More than 15% were classified to be obese according to the WHO definition. We observed a significantly higher frequency of injury in obese people, in boys, in subjects playing sport intensively, with members of a sports club and in those reporting more than one physical activity per week. In multivariate analysis for injury, gender, physical activity, playing sport in a club and obesity were significant. For severe injuries, only gender and physical activity remained significant in the multivariate analysis.

CONCLUSION

Our analysis shows that childhood obesity and physical activity increase the occurrence of injuries. However, we did not observe an association between obesity and severe injuries. Obesity as a risk factor for the occurrence of injuries has to be confirmed by other studies, and the understanding of the mechanism for the observed association needs more investigation.

A Meta-Analysis of Clinical Correlates that Predict Significant Intracranial Injury in Adults with Minor Head Trauma

Previous studies have resulted in conflicting results regarding the predictive effect of various clinical symptoms, signs, and plain imaging for intracranial pathology in adults with minor head injury. We sought to perform a meta-analysis of the literature to assess the significance of these factors for the prediction of intracranial hemorrhage (ICH). The literature was searched using Medline, Embase, Experts, and the Grey literature. Reference lists of major guidelines were crosschecked. Included were control or nested case control studies of patients attending hospital with head injury that recorded clinical correlates relating to the outcome variable of presence or absence of ICH. The common relative risk ratio was calculated using the Mantel-Haenszel test with a pooled estimate. Thirty-five papers containing 83,636 patients were included in the meta-analysis after systematic review of the literature. Relative risk ratios were calculated for 23 clinical correlates from the history, the mechanism of injury, and the examination. In addition, adjusted relative risks were presented for those variables that showed significant heterogeneity across studies. Reasons for the heterogeneity are discussed. This study has determined the relative risks of 23 clinical variables that may predict the presence of an ICH in patients after minor head injury. These risks should prove invaluable to clinicians for the assessment of individual patients as well as the assessment of guidelines presented for the management of minor head injuries.

Self-reported injuries among seafarers. Questionnaire validity and results from an international study

International surveys of occupational injuries among seafarers have so far been missing. It was the aim to test the method of self-report of injuries and length of time at risk during the latest duty period and second to study the injury incidence rate among seafarers by use of the method. A pilot study was conducted (n = 1068) in Finland, Denmark, the Philippines, Croatia and Spain using self-completed questionnaires with questions about the person, the ship, the duration of latest duty period and injuries. The duration of the self-reporting duty period was in the Danish part compared with information from the crew register of the Maritime Authority. For seafarers from merchant ships in the Danish sub-study there was acceptable correspondence between the information from the seafarers and the Maritime Authority, but not when referring to ferries and non-specified types of ship. Unadjusted and adjusted injury incidence rates-ratios (IRRs) based on number of injuries per number of work hours were calculated. Adjusted IRRs for ordinary seamen/officers: IRR = 2.43 (95% CI: 1.25-4.72); for age < 35/35+ years: IRR = 1.97 (1.02-3.81); length of tour: 117 days or longer compared with < 117 days: IRR = 0.46 (95% CI: 0.22-0.95); 57-70 working hours per week compared with < 57 h: IRR = 1.26 (0.48-3.29), 71+h compared with < 57 h: IRR = 2.12 (0.84-5.36). Non-significant IRRs >1.00 were found for ships under 10,000 GT compared with larger ships and for own flagged ships compared with ships under flag of convenience. In conclusion, more than 70 h of work per week was related to a higher rate of injuries for seafarers on merchant ships, but the result was not statistically significant. Self-report of the duration of the latest tour of duty is useful for seafarers from merchant ships with short-term employments, but not for ferries and other, non-specified types of ship with other or permanent employment.

Trends in head injury mortality among 0-14 year olds in Scotland (1986-95)

STUDY OBJECTIVE

To examine the trends in childhood head injury mortality in Scotland between 1986 and 1995.

DESIGN

Analysis of routine mortality data from the registrar general for Scotland.

SETTING

Scotland, UK.

SUBJECTS

Children aged 0-14 years.

MAIN RESULTS

A total of 290 children in Scotland died as a result of a head injury between 1986 and 1995. While there was a significant decline in the head injury mortality rate, head injury as a proportion of all injury fatalities remained relatively stable. Boys, and children residing in relatively less affluent areas had the highest head injury mortality rates. Although both these groups experienced a significant decline over the study period, the mortality differences between children in deprivation categories 1-2 and 6-7 persisted among 0-9 year olds, and increased in the 10-14 years age group. Pedestrian accidents were the leading cause of mortality.

CONCLUSIONS

Children residing in less affluent areas seem to be at relatively greater risk of sustaining a fatal head injury than their more affluent counterparts. While the differences between the most and least affluent have decreased overall, they have widened among 10-14 year olds. The decline in head injury mortality as a result of pedestrian accidents may be partly attributable to injury prevention measures.

Sports related injuries in Scottish adolescents aged 11-15

OBJECTIVES

To measure the age and sex distribution of self reported sports and leisure injuries in a 12 month retrospective recall period among a representative national sample of Scottish adolescents, and to examine the characteristics (gender, age, handedness, and level of sports participation) of sports related injuries in relation to injuries sustained during other activities.

DESIGN/SETTING

Self completion questionnaire survey administered in schools during April-June 1994.

SUBJECTS

4710 pupils aged 11, 13, and 15 years drawn from a representative sample of 270 classes with returns from 224 classes (83% completion rate).

RESULTS

42.1% of the sample reported a medically attended injury. These were significantly more frequent among boys but there were no significant age differences in overall frequency of injury. Sport related injuries accounted for 32.2% of all medically attended injuries. As with all injuries, frequency was greater in boys than girls at all ages, and there are differences in the pattern of lesions in sports and nonsports injuries. Lower limb injuries were more frequent than upper limb injury in sports (57.6 v 23.9%), whereas there were no differences in non-sports injuries (31.5 v 31.3%). Age and handedness differences in sports injury rates were also identified. High sports participation was significantly associated with a higher risk of injury in general and sports related injury in particular.

CONCLUSION

Age, gender, handedness, and level of sports participation have been shown to be implicated in differential risk of sports related injury. Reducing sports injury among adolescents should be a priority, but research into the injury profiles of different sports is needed before detailed injury prevention strategies can be developed.

Measures of injury severity in childhood: a critical overview

Many different methods for assessing injury severity have appeared in the literature. This paper discusses the commonly used measures, many of which are subjective and depend on clinical practice or sociological factors. Even if apparently objective measures are used their appropriateness for use in children is questionable. Particular problems occur with scoring or categorising events such as poisoning, choking, and near drowning. Researchers need to reach a consensus on injury severity reporting to ensure comparability between studies and programs for injury prevention.

Minor head injury

Head injury is common in children, although the incidence of brain injury is much lower. Most children who sustain an injury to the head will only have a minor injury. Careful history, examination, and judicious use of radiology will identify those children at risk of brain injury. Children with no significant risk of brain injury may be safely discharged home to the care of responsible adults. Further work is needed to address sequelae after minor head injury.

Socioeconomic status and adolescent injuries

Injuries are the major cause of morbidity among children and adolescents in developed countries, but there is a lack of consensus on the relationship between socioeconomic status and risk of injuries. A self-complete questionnaire survey, to gather information on non-fatal injuries and sociodemographic details, was administered in schools during April-June 1994 to a national sample of 4710 Scottish adolescents aged 11, 13 and 15 years. Although there was no evidence of a socioeconomic gradient in the total incidence of medically attended injuries among adolescents, based on the Registrar General's classifications of paternal occupation and a composite measure of family affluence, marked socioeconomic variation in the circumstances in which injuries occurred was observed. There were also socioeconomic differences in the extent and type of risk behaviours reported by adolescents, indicating differential rates of risk exposure. The finding that socioeconomic status affects the kinds of injury events adolescents experience and levels of risk behaviour has implications for the design of injury prevention strategies.

Left-handedness increases injury risk in adolescent girls

In a self-report survey of a representative national sample of 4081 Scottish schoolchildren, injuries requiring medical assistance were more common in left-handers; these were also more severe and likely to involve an overnight stay in hospital. Particularly at risk were adolescent girls with a 32% greater chance of being injured if they were left-handed compared with their right-handed peers. The corresponding relative risk for boys was not significant.