title: Trends in unintentional injury mortality in Canadian children 1950-2009 and association with selected population-level interventions.
abstract: To examine unintentional injury mortality rates in children (0-19 years) in Canada from 1950 to 2009 against national population-level injury prevention interventions.
  
  
  
  Injury mortality rates were age and sex adjusted. Changes in trend and level of mortality rates were assessed at pre-specified intervention periods using segmented linear regression analyses for interrupted time series. Maximum likelihood estimation was used with a second order autoregressive error process.
  
  
  
  From 1950 to 2009, the overall unintentional injury mortality rate decreased by 86%. Males had consistently higher mortality rates compared to females; however, the standardized rate ratio decreased from 2.37:1 in 1950 to 1.97:1 in 2009. Substantial declines in choking/suffocation deaths were noted in children less than 1 year of age, predominantly during the period 1970-1988 when the Hazardous Products Act and Crib Regulations were implemented. For burns, significant changes in slope were noted comparing 1972-1994 to pre-1971 (introduction of the Hazardous Products Act - Flammability Regulations), where the greatest decline was noted in children ages 1-4 years (Est. = -0.03, 95% CI = -0.02, -0.04). For 15-19 year olds, there was a 408% increase in motor vehicle collision-related mortality rates between 1950 and 1971; however a significant change in slope was noted during the period 1978-1985, compared to 1972-1977 (Est. = -0.10, 95% CI = -0.20, -0.007) across all age groups.
  
  
  
  While this study is not a cause and effect analysis, there is a strong association with implementation of safety campaigns and legislative changes related to child safety and a dramatic decline in childhood fatalities related to injury.
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, ON; Department of Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON. sarah.a.richmond@gmail.com.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Richmond
authors.forename: Jennifer
authors.initials: J
authors.lastname: D'Cruz
authors.forename: Armend
authors.initials: A
authors.lastname: Lokku
authors.forename: Alison
authors.initials: A
authors.lastname: Macpherson
authors.forename: Andrew
authors.initials: A
authors.lastname: Howard
authors.forename: Colin
authors.initials: C
authors.lastname: Macarthur
mesh_terms: D000056:Accident Prevention; D000059:Accidents / Q000401:mortality*; D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009026:Mortality / Q000639:trends; D014947:Wounds and Injuries / Q000401:mortality* / Q000517:prevention & control; D055815:Young Adult