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The epidemiology of injuries in 4 child care centers
A Alkon1, J L Genevro, J M Tschann
1Department of Family Health Care Nursing, University of California, San Francisco 94143-0606, USA. abbeyalk@uclink4.berkeley.edu
Insights
Child care injuries are common, with most being minor and occurring during free play. Boys experienced higher injury rates than girls, highlighting the need for targeted prevention strategies in child care settings.
Area of Science:
- Pediatrics
- Public Health
- Child Development
Background:
- Child care settings are environments where preschool-aged children spend significant time.
- Understanding injury patterns in child care is crucial for developing effective prevention strategies.
Purpose of the Study:
- To characterize injury patterns in preschool children attending urban child care centers.
- To compare injury rates across different demographic factors and child care centers.
- To identify environmental and child-related factors associated with injury severity.
Main Methods:
- A 2-year prospective cohort study involving 362 preschool children across 4 urban child care centers.
- Standardized injury forms completed by teachers documented injury type, location, and contributing factors.
- Injury rates were calculated per 2000 exposure hours.
Main Results:
- A total of 1886 injuries were reported, with a median injury rate of 4 per 2000 exposure hours.
- The majority of injuries (87%) were minor, frequently occurring during free play (81%) on playgrounds (74%) and often precipitated by child-related factors (59%).
- Boys exhibited significantly higher median injury rates than girls, and significant differences in injury rates were observed between child care centers.
Conclusions:
- Injury surveillance in child care settings is vital for identifying risk factors and informing prevention programs.
- Further research is needed to explore children's behavior and the child care environment's role in injury causation.
- Findings underscore the importance of addressing both child-specific behaviors and environmental factors in child care injury prevention.
Objectives:
(1) To describe the pattern of injury in preschool-aged children in 4 child care centers as compared with the results of other studies; (2) to compare injury rates by sex, age, and child care center; and (3) to examine environmental and child factors contributing to injury severity.
Design:
A 2-year cohort study of 362 preschool-aged children attending 4 urban child care centers. Teachers completed standardized injury forms on the type of injury, body location, site of injury, and contributing factors.
Results:
During the 2 years of the study, 1886 injuries were reported. The mean and median child injury rate was 6 and 4 injuries per 2000 exposure hours (equivalent to 1 full-time child care year), respectively. The majority of injuries (87%) were minor, occurred during free play (81%) and on the playground (74%), and were precipitated by child-related factors (59%), such as being pushed. Boys had significantly higher median injury rates than girls. Age-adjusted injury rates for each child care center were significantly different by center (F3 = 61, P<.001). While moderate to severe injuries were more often precipitated by combinations of child and environmental factors (chi2(4) = 20, P<.001), minor injuries were usually precipitated by child-related factors.
Conclusions:
Injury data from child care centers are important for identifying common risk factors for frequent or severe injury events and for designing injury prevention programs. More research is needed to identify factors contributing to injuries, such as children's behavior and the child care centers' physical and socioemotional environments.