title: Trauma does not happen at random. Predictable rhythm pattern of injury occurrence in a cohort of 15,110 children.
abstract: BACKGROUND
  Several adult chronobiologic studies have shown that accidents do not occur at random. Comparing a large cohort of injured children with uninjured children living in an urban setting, we evaluated the rhythmicity of pediatric injury occurrence.
  
  
  METHODS
  A data review of a prospective cohort study of child trauma over an 8-year period was recorded in a Swiss urban setting. Chronological and demographic information of preschool as well as school-aged injured children were compared with a similar sample of children assessed in the emergency department for nontraumatic events.
  
  
  RESULTS
  Statistically significant circadian rhythms of injury occurrence were detected with a peak around 4 pm . No sex- or age-related differences were detected between preschool and school-aged children. Type of activity and place of occurrence revealed statistically significant differences in the circadian rhythm of trauma occurrence. No weekly rhythm was validated. A circannual rhythm was validated with a peak on June 14 (+/-10 days).
  
  
  CONCLUSIONS
  Pediatric trauma did not occur at random. Circadian rhythms of pediatric trauma were not influenced by age, sex, or motor vehicle traffic load. Specific circadian and circannual pattern of injury occurrence in children could influence safety campaigns and prevention programs, as well as optimize workforce distribution in medical facilities.
authors.affiliation: Department of Pediatric Surgery, University Hospital of Lausanne (CHUV), CH 1011-Lausanne, Switzerland. olivier.reinberg@chuv.hospvd.ch
authors.forename: Olivier
authors.initials: O
authors.lastname: Reinberg
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lutz
authors.forename: Alain
authors.initials: A
authors.lastname: Reinberg
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mechkouri
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D015331:Cohort Studies; D016208:Databases, Factual; D004630:Emergencies / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012621:Seasons; D013557:Switzerland / Q000453:epidemiology; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000601:surgery