Epidemiological characteristics and burden of childhood and adolescent injuries: a survey of elementary and secondary students in Xiamen, China

BACKGROUND Injuries pose a considerable threat to the health of children and adolescents, and childhood injuries cause substantial economic loss for families and society. Many injuries are preventable. To provide a theoretical basis and empirical support for injury prevention interventions, we studied the epidemiological characteristics, risk factors, and burden of injuries among elementary and secondary school students in Xiamen, China. METHODS Participants were enrolled through multi-stage stratified cluster random sampling of elementary and secondary students in Xiamen in 2010. Questionnaires were completed by students' parents or guardians to assay students' basic information, family background, occurrence of injuries in the past year, and burden of injuries. Chi-square tests and logistic regression were performed to identify the key factors of injuries. RESULTS A total of 2,816 usable questionnaires reported 365 injury incidents in 303 students over 1 year. The incidence of injuries was 10.8%. Students who were male, extroverted, suburban, had sibling(s), studied in grades 4-9, or whose parents were divorced or separated were more likely to suffer from injuries. Most injuries occurred during the summer months (from June to August), and in the afternoon. The main affected body parts were limbs, fingers or toes. Unintentional falls, collisions/strikes, sprains, and cuts/sharp instrument injuries were the predominant causes of injury. The overall economic burden of the 365 injury incidents was 1,014,649.1 RMB (148,666.5 USD) total, 3,348.7 RMB (490.65 USD) per capita, and 2,779.9 RMB (407.31 USD) per incident. CONCLUSION The injury incidence among elementary and secondary students in Xiamen, China is lower than Guangdong and Zhejiang but higher than Beijing and Shanghai. Injuries caused substantial economic and family burdens and threatened students' health and life. Childhood and adolescent injuries have become a serious public health problem that requires the urgent attention of the government, society, schools, and families. Injury control and prevention among elementary and secondary school students is essential and will help in multiple ways to reduce the burden on the family to build a harmonious family and society.