title: Road traffic injuries among middle school students in a rural area of China.
abstract: OBJECTIVE
  Injuries resulting from road traffic crashes are a major and growing public health problem worldwide, disproportionately affecting vulnerable road users in developing countries. However, research on road traffic injuries in developing countries has been limited. We studied road traffic injuries among middle school students in a rural area of China.
  
  
  METHODS
  We surveyed 1551 students in Hunan province using a hard-copy survey questionnaire. The survey was conducted at two middle schools with the cooperation of teachers and school officials. The questionnaire gathered data including sociodemographics, school activities, and sleep patterns along with road traffic injuries among middle students during a 3-month recall period in 2006. Road traffic injuries were defined as injuries incurred as a result of a road traffic collision involving at least one vehicle in motion on a public or private road that resulted in at least one person being injured.
  
  
  RESULTS
  There were 56 road traffic injuries reported by the surveyed students yielding a rate of 3.6 percent over the 3-month period. The greatest percentage of those injuries involved a motorcycle (80%). Nearly two fifths of injuries resulted in a period of activity restriction lasting one day or more (39%). The multivariable logistic regression analysis indicated that there were statistically significant associations between the assignment of extra homework by parents (odds ratio [OR] = 3.78, 95% confidence intervals [CI] = 1.49-9.60, p-value < 0.01) and parents' treatment for poor academic performance (OR = 2.18, 95% CI = 1.18-4.02, p-value < 0.05) with road traffic injuries and difficulty falling asleep was a marginally a significant risk factor (OR = 2.03, 95% CI = 0.78-5.28, p-value = 0.06).
  
  
  CONCLUSIONS
  School-related stress and sleep disturbance were identified as possible risk factors for road traffic injuries among students in a rural area of China. Further research is warranted in order to develop prevention strategies to address these preventable injuries.
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, College of Medicine, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Jaung
authors.forename: Songlin
authors.initials: S
authors.lastname: Yu
authors.forename: Lorann
authors.initials: L
authors.lastname: Stallones
authors.forename: Huiyun
authors.initials: H
authors.lastname: Xiang
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D001334:Automobile Driving; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012424:Rural Population; D012890:Sleep; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000453:epidemiology*