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Epidemiology of human bites to children in a day-care center
J Garrard1, N Leland, D K Smith
1Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis 55455.
Insights
Toddlers experienced the highest rates of human bites in a day-care setting, with bite incidence varying by age group. This study highlights the need for updated policies on managing and reporting child day-care bites.
Area of Science:
- Pediatrics
- Epidemiology
- Child Care Health
Background:
- Human bites among children in group settings pose a significant health concern.
- Day-care centers require injury logs for regulatory compliance, providing a data source for epidemiological studies.
Purpose of the Study:
- To investigate the epidemiology of human bites among children in a day-care center.
- To analyze bite rates across different age groups and demographic factors.
- To examine the circumstances and characteristics of biting incidents.
Main Methods:
- A cohort study design was employed, utilizing daily injury logs from a day-care center.
- Data collected included child demographics, bite occurrences, and details of each incident over a one-year period.
- Bite rates were calculated per 100 child days of enrollment, differentiating between initial and total bites.
Main Results:
- A total of 347 human bites were recorded among 104 children out of 224 enrolled.
- Bite rates varied significantly by age group, with toddlers exhibiting the highest incidence (initial bites: 1.3672; total bites: 3.1300 per 100 child days).
- While overall gender differences were not significant, male toddlers had higher total bite rates than female toddlers (3.6683 vs. 2.3096 per 100 child days).
Conclusions:
- Toddlers are the most vulnerable age group for human bites in day-care settings.
- The study underscores the need for re-evaluating current policies regarding the treatment, recording, and reporting of human bites in child care.
- Further research into preventative strategies and ethical reporting practices is warranted.
Abstract:
The purpose of this study was to examine the epidemiology of human bites to children in a day-care center over a one-year period. This was a cohort study based on the injury log maintained on a daily basis by staff of the day-care center, as required by state II-censure law. A total of 224 children was enrolled in the center during the study period: 29 infants (ages 0 to 16 months), 62 toddlers (16.1 to 30 months), and 133 preschoolers (30.1 to 72 months). One hundred four children were bitten one or more times by other children in the center, with a total of 347 bites. The bite rates (defined as number of bites per 100 child days of enrollment in the center) varied significantly by age group but not by gender for initial or first-time bites, with toddlers having the highest rate and preschoolers the lowest (infants, 0.7129; toddlers, 1.3672; preschoolers, 0.4193). Total bite rates (which took into account multiple bites per child over the 12-month study period) varied significantly by age group, with toddlers having the highest rate per 100 days of enrollment and preschoolers the lowest (infants, 2.1931; toddlers, 3.1300; preschoolers, 0.5611). Males and females differed significantly in total bite rates per 100 enrollment days within the toddler age group (males, 3.6683; females, 2.3096) but not within the other two age groups. None of the demographic characteristics available in this study distinguished between children who were bitten compared with those who were not bitten with the exception of number of days of enrollment. The circumstances surrounding the biting events were examined with respect to the activity of the child when bitten, the victim's location when bitten, body part bitten, and treatment by staff. The results of this study raise policy questions about treatment protocols for human bites of children in group child-care settings, the routine recording of biting events, and the ethics and practice of reporting such events to parents.