Unintentional injuries in infants in Singapore.
BACKGROUND
To describe the risk factors, causes and outcome of infant injuries so as to guide the formulation of injury prevention strategies specific for Singapore babies less than one year old.


METHODS
Demographical, socio-economic data, and data on the circumstances of injury, nature, severity of injury and clinical outcome of all infants less than one year old and who sought medical attention for or died from unintentional childhood injuries or poisoning, at the Emergency Departments of three SingHealth hospitals, two SingHealth primary care polyclinics and the Forensic Medicine Department, Health Sciences Authority during a six-month period, were extracted from a larger Childhood Injuries Surveillance database and analysed.


RESULTS
405 cases of accidental injury and poisoning in infants aged less than one year were seen from February to July 2002. 40.5 percent of injuries occurred when infants were left alone. Most infants were aged between nine months to one year (37 percent), male (57.3 percent), first-born (57.3 percent) and Chinese (69 percent), with no past medical history (96.1 percent). 91 percent of the injuries occurred at home, of which 60.5 percent occurred in the bedroom. Falls were the major mechanism of injury (77 percent). A total of 431 injuries were sustained. 63 percent were head injuries - mainly stable head injuries, which made up 93.1 percent of all the head injuries. 67.5 percent of the cases were discharged without follow-up, while 17.9 percent required hospital admission, mostly to the general ward (98.6 percent of total admissions), and to the neurosurgery department (84.9 percent of total admissions). There were two fatalities in this study population. The mechanisms and patterns of injury changed with increasing motor ability of the infants.


CONCLUSIONS
Parents and caregivers of infants should be taught and reminded about the age specific measures in injury prevention as their wards go through the various developmental stages in the first year of life. Emphasis should be placed on close caregiver supervision, identifying potential injury hazards in the home, fall prevention, adopting safe infant care practices and the safe use of infant care products.
Snodgrass
A M
AM
Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore. amsnodgrass@yahoo.co.uk
Ang
A
A
D000056:Accident Prevention; D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000517:prevention & control / Q000706:statistics & numerical data*; D016208:Databases, Factual; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011041:Poisoning / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control