Age-specific disparities in temperature-related injury risks and burdens among Chinese children

Injury is a major cause of morbidity and mortality among children, yet evidence on the influence of ambient temperature on childhood injury remains limited. This study quantified the association between temperature and child injury across age groups in China from 2006 to 2021 and projected the future burden attributable to temperature under climate change scenarios. Injury data were derived from the National Injury Surveillance System, and meteorological data were obtained from the fifth generation of the European ReAnalysis-Land dataset. Conditional logistic regression combined with distributed lag non-linear models was used to estimate temperature-injury associations, with stratified analyses by sex, injury mechanism, and location. A total of 1,849,211 injury cases among children were included. Temperature showed an approximately linear relationship with injury risk, with a 1.14 % (95 %CI: 1.08 %, 1.20 %) increase in child injury risk for each 1 °C rise. Children aged 2-4 years were most vulnerable, exhibiting a 1.36 % (95 %CI: 1.24 %, 1.48 %) excess risk. Under the SSP5-8.5 scenario, the temperature-attributable fraction for this group is projected to increase from 0.58 % (95 %CI: 0.53 %, 0.62 %) in the 2020s to 6.87 % (95 %CI: 6.27 %, 7.54 %) in the 2090s. Traffic injuries accounted for the largest burden among children aged 0-9 years, while sharp instrument injuries predominated in those aged 10-14 years. These findings indicate that rising ambient temperatures substantially increase childhood injury risk, particularly among younger age groups, and that climate change may amplify the future burden of temperature-related injuries in China.