[Childhood accidents in primary health care]

Accidents in childhood are an important health problem, mainly in situations of social and environmental risk. Additionally, the lack of studies in primary health care, encouraged us to set up a study in order to establish the characteristics of accidents in childhood attended in a health center, their relation with the child's socio-familiar situation and medical care delivered.

We describe children's accidents occurred in our area (2,543 children 0-14 years old, 788 of them living in deprived neighbourhoods) during 1992 attended in the health center. Study data was collected from data included in emergencies and medical records of the health center. We included information on: age, sex, socio-familiar situation, accident, lesion, and health care delivered characteristics.

We include 623 accidents: annual cumulated incidence = 245/1,000 children; males were more affected (58.4%); the accidents occurred mainly in the household (35.6%); the most frequent causes were blows (39.9%) and falls (30.5%); the most frequent lesions were injuries (29.7%) and blows (25.7%). Location of the lesions were the superior limbs (33.5%) and head and neck (25.98%). About 12.5% were delivered to the hospital, 17.8% of them required inpatient care, one died. Children of deprived boroughs have a relative risk of being attended for accident in our center of 4.2 (CI 95% = 3.64-4.84) compared with the rest of the area. 79 children have had repeated accidents, they occurred mainly in only 27 families, 92.6% of whom live in deprived areas.

Our health center is attending a high frequency of children's accidents, most of them can be treated in the health center, the cases are concentrated in deprived boroughs and in risk families.