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Residential injuries in U.S. children and adolescents
Kieran J Phelan1, Jane Khoury, Heidi Kalkwarf
1Division of Health Policy and Clinical Effectiveness, Cincinnati Children's Hospital Medical Center and Cincinnati Children's Environmental Health Center, Cincinnati, OH 45229, USA. kj.phelan@cchmc.org
Insights
Unintentional home injuries cause millions of emergency department visits for US children annually. Targeted home safety efforts are crucial to reduce child injury and mortality.
Area of Science:
- Pediatric injury prevention
- Public health surveillance
- Environmental health and safety
Background:
- Injuries are a leading cause of death and disability in U.S. children.
- Limited research exists on the specific issue of home injuries among children.
- Understanding residential injury patterns is critical for effective prevention strategies.
Purpose of the Study:
- To estimate the incidence and severity of unintentional residential injuries among U.S. children younger than 20 years.
- To analyze trends in these injuries from 1993 to 1999.
- To identify high-risk age groups and injury mechanisms within the home environment.
Main Methods:
- Utilized data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for emergency department (ED) visits.
- Calculated injury rates and confidence intervals using SUDAAN statistical software.
- Employed chi-square analysis for proportional differences and linear regression for trend analysis.
Main Results:
- An average of 4.01 million annual ED visits for residential injuries in U.S. children, representing 39% of all unintentional injury ED visits.
- Approximately 531,000 moderate-to-severe injuries and 73,680 hospital admissions annually.
- Falls were the primary cause, and injury rates decreased by 28% from 1993 to 1999.
Conclusions:
- The home is the primary location for unintentional injuries among U.S. children, leading to millions of ED visits and thousands of hospitalizations yearly.
- Significant morbidity and mortality associated with residential injuries underscore the need for focused prevention efforts.
- Interventions targeting the home environment are essential to reduce the burden of unintentional injuries in children.
Objectives:
Injuries are the leading cause of death and disability for U.S. children, but little research exists on injury in the home environment. The purpose of this study was to estimate the rate and severity of and trends in unintentional residential injury for U.S. children <20 years for 1993-1999.
Methods:
Data on emergency department (ED) visits were obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Rates and 95% confidence intervals (CIs) were calculated using SUDAAN. Chi-square analysis was used to test for differences among proportions. Time trends were analyzed using linear regression.
Results:
Residential injuries accounted for an average of 4.01 million (95% CI 3.50 million, 4.56 million) ED visits each year for U.S. children, representing 39% of unintentional injury ED visits. There were an average of 531,000 (95% CI 456,000, 606,000) visits with moderate-to-severe injuries, resulting in 73,680 (95% CI 59,715, 87,645) hospital admissions annually. The rate of residential injury visits (excluding unknown locations) was 5.6 per 100 (95% CI 4.9 per 100, 6.4 per 100). The visit rates for children <5 years of age were higher than those for children >9 years (p<0.0001). Males had a higher rate of visits than females (p=0.01). Falls were the leading mechanisms, resulting in 1.5 million ED visits per year (95% CI 1.3 million, 1.8 million). Residential injury rates decreased by 28% over time (p<0.02), from 6.3 per 100 (95% CI 3.4, 9.2) in 1993 to 4.5 per 100 (95% CI 2.3, 6.7) in 1999.
Conclusions:
The predominant location of injury for U.S. children is the home, accounting for 4.01 million ED visits and more than 70,000 hospitalizations each year. Efforts targeted to the home environment are needed to reduce morbidity and mortality from unintentional injury in U.S. children.
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