Pupil injury risks as a function of physical and psychosocial environmental problems experienced at school.

OBJECTIVES To investigate relations between physical and psychosocial environmental problems in schools, as perceived by school principals, and injuries among pupils. METHOD Proportionate injury ratios (PIRs) were computed for 77 public sector Swedish schools (33,248 pupils), and divided into four classes based on types of environmental problems reported. Sports related injuries, injuries during recesses, and violence related injuries were considered. RESULTS The schools reporting psychosocial problems (9.1% of schools and 7.3% of pupils) had more injuries than expected by chance than all types of injuries aggregated (PIR = 1.92; 95% confidence interval (CI) 1.64 to 2.27), and in the case of sports related injuries (PIR = 1.79; 95% CI 1.37 to 2.34) and injuries due to physical violence (PIR = 2.20; 95% CI 1.33 to 3.65). There were no significant excess risks of injuries for schools facing physical problems or a combination of physical and psychosocial problems. CONCLUSIONS Psychosocial problems may exacerbate the risk of intentional and unintentional injuries among pupils. The results offer a reminder that school environment must be planned as part of any assessment of youth safety.