School injuries and preventive policies and programs.

BACKGROUND Injuries are a major source of morbidity and mortality throughout childhood and many occur on school premises. Differences in policies, programs and practises at the level of school boards or individual schools may account for some of the differences in injury rates among schools. METHODS We used data from the Montreal Children's Hospital to identify children injured at school. By telephone interview, we identified the school attended and calculated injury rates per school for the study year. A questionnaire to principals identified practises and programs. The two data sets were merged and the data analyzed using cross tabulations and logistic regression. RESULTS Nearly one third of the 310 injured children required admission or follow up. Most involved falls, boys, 10-14 year olds, and sports. The variables associated with higher rates of injuries were: school board (English), proximity to hospital, wood gym flooring, gym use during breaks, presence of a playing field, frequent checks of field surface, and the presence of an injury prevention program. Using logistic regression, after controlling for all other variables in the model, only school board and distance to hospital remained significant. CONCLUSION These findings provide little support for the notion that school policies influence injury rates. If anything, they suggest that the reverse may be true; i.e., that injury rates help stimulate schools to take certain preventive actions. An alternative explanation is that many of the differences observed among schools simply reflect differences in the extent to which their pupils are exposed to the risk of injury because of, for example, the availability of sports facilities.