Emergency department visits for injury in school-aged children in the United States: a comparison of nonfatal injuries occurring within and outside of the school environment.
OBJECTIVE
To compare the demographic and injury characteristics of children visiting the emergency department (ED) for nonfatal injuries occurring at school with those of same-aged children who were injured outside of school.


METHODS
Data from a stratified probability sample of U.S. hospitals providing emergency services in the National Electronic Injury Surveillance System (NEISS) were analyzed for 2001 and 2002. School and nonschool injury-related ED visits were analyzed for patients who were 5 through 19 years of age.


RESULTS
There were an estimated 58,147,518 injury visits in all ages to the ED in 2001 and 2002. Injuries to school-aged children (ages 5-19) accounted for an estimated 15,405,392 (26%) visits overall, of which 1,859,215 occurred at school (16.5% of visits by school-aged children when location of injury was known). Males accounted for 63% of injuries at school; middle-school children (ages 10-14 yr) accounted for a significantly greater proportion of injuries (46%) than did primary- (5-9 yr, 24%) or secondary-school (15-19 yr, 30%) children (p < 0.001). In contrast, for injuries outside of school, secondary-school children were injured most (40%), followed by middle- (32%) and primary-aged children (27%). Nearly 11% of school injuries were classified as violent, whereas only 6.4% of the nonschool injuries in school-aged children were violent (p < 0.001). Similarly, sports injuries were significantly more common at school (53% of injuries) than outside of school (32.9%; p < 0.001).


CONCLUSIONS
A significant proportion of injuries to school-aged children occur at school. Notable differences exist between the epidemiology of in- and out-of-school injuries. The nature of these injuries differs by age group. Efforts to reduce school injuries will require that these differences be examined further and incorporated into prevention initiatives.
Department of Emergency Medicine,Brown Medical School, Providence, RI, USA. james_linakis_phd@brown.edu
James G
JG
Linakis
Siraj
S
Amanullah
Michael J
MJ
Mello
D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001265:Athletic Injuries / Q000453:epidemiology; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012574:Schools / Q000706:statistics & numerical data*; D017678:Sex Distribution; D013334:Students / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*