Academic journal article Journal of School Health

Epidemiology of School Injuries in Utah: A Population-Based Study

Academic journal article Journal of School Health

Epidemiology of School Injuries in Utah: A Population-Based Study

Article excerpt

Injuries to children constitute a major public health problem. Every year nearly 22 million children are injured in the United States.[1] Seventy percent of childhood injuries occur in school-aged children. Injuries are common in schools.[1-8] Approximately 80% of elementary school students visit a school nurse for injury-related complaints.[4] Recent studies demonstrated the financial impact of school injuries. Based on National Health Interview Survey data, an estimated 3.7 million US children suffer substantial injury at school, resulting in $3.2 billion in medical spending and $115 billion in good health lost.[9]

Comprehensive information on the character and distribution of school injuries is scarce. In 1984, Boyce et al[4] reported one of the largest studies of school injuries. This prospective analysis of 5,379 injuries occurring in a large, urban US school district showed an overall injury rate per 1,000 students-years of 49.[4] Considerable variability was found among injury rates for individual schools. In another large study, DiScala et al[10] found that most injuries were unintentional and occurred among students ages 10-12. In 1992, Grantz,[11] in a retrospective review of school injury publications, noted a lack of operational definitions in reporting and of consensus in categorizing serious school injuries. In addition, many of the causes of school injuries are not clearly identified, and minimal work has been conducted on repeat school injuries.

Since 1989, the Violence and Injury Prevention Program of the Utah Dept. of Health has collected standardized data on school injuries occurring in all public school districts. To describe the epidemiology of school-related injuries in Utah, data were analyzed to determine baseline school injury rates, identify types of injuries and mechanisms involved, identify high-risk groups, situations, and activities, and assess injury outcome.


School injury data from 1990-1997 were analyzed. Data were generated from a standardized Student Injury Report (SIR) form completed by school personnel (ie, secretary, school nurse, counselor, coach, teacher, etc.) immediately following the occurrence of an injury occurring at school, going to or from school, or during a school-related activity. In addition, the injury must have met one of the following criteria: 1) cause loss of at least one-half day of school; and/or 2) warranted medical attention and treatment (eg, school nurse, physician or other healthcare provider, or healthcare facility). The SIR forms were used in all Utah school districts. A technician reviews each form before it is entered into the database, communicates with schools regarding the consistency of reporting, and provides training to improve the accuracy of reporting.

Use of these forms is voluntary, however, compliance has been consistent from year to year, and this form is the only means to report student injuries to the health department. Items on the form include student demographics, time and date of injury, place (school and district), number of missed days, action taken (ie, first aid, called 911, taken to a physician, etc.), nature of injury, body area affected, contributing factor, school setting, surface involved, location (ie, athletic event, classroom, gymnasium, shop class, laboratory, etc.), activity during which injury occurred, equipment involved, malfunction of equipment, and equipment misuse.

Because exposure to injury differs between K-6 grades and 7-12 grades, these groups were analyzed separately. These groups were compared using rates and t-test. Rates were based on yearly enrollment numbers obtained from the Utah Office of Education. Confidence intervals were set at 95% and significance set at p [is less than] .05 for all comparisons.

To analyze the relationship between the type of outdoor surface and injury severity, the project studied primary school injuries (K-6) due to a fall while playing on bars, swinging, or climbing. …

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