title: Epidemiology of poisonings, fractures and burns among 0-24 year olds in England using linked health and mortality data.
abstract: Understanding patterns of injury in England is challenging due to a lack of national injury surveillance data. Through recent linkage of a large primary care research database to hospitalization and mortality data, we describe the epidemiology of poisonings, fractures and burns over a 14-year period.
  
  
  
  We used linked English primary care, hospitalisation and mortality data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics between 1998 and 2011 to establish a cohort of 2,106,420 0-24 year olds. Incidence rates, per 10 000 person-years (PY) were estimated by age, sex, calendar year and socioeconomic status. Using Poisson regression we estimated incidence rate ratios, adjusting for age and sex.
  
  
  
  Age patterns of injury incidence varied by injury type, with peaks at age 2 (74.3/10 000 PY) and 18 (74.7/10 000 PY) for poisonings, age 13 for fractures (305.1/10 000 PY) and age 1 for burns (116.8/10 000 PY). Over time, fracture incidence increased, whereas poisoning incidence increased only among 15-24 year olds and burns incidence reduced. Poisoning and burns incidence increased with deprivation, with the steepest socioeconomic gradient for poisonings among 20-24 year olds (IRR 2.63, 95% confidence interval 2.24-3.09).
  
  
  
  Differing patterns according to age and injury type reflect differences in underlying injury mechanisms, highlighting the importance of developing tailored preventative interventions across the life course. Inequalities in injury occurrences support the targeting of preventative interventions to children and young people living in the most deprived areas.
authors.affiliation: Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK mcxrb12@nottingham.ac.uk.
authors.forename: Ruth
authors.initials: R
authors.lastname: Baker
authors.affiliation: Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Orton
authors.affiliation: Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Laila J
authors.initials: LJ
authors.lastname: Tata
authors.affiliation: Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002056:Burns / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011041:Poisoning / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D017678:Sex Distribution; D012923:Social Class; D055815:Young Adult