Recurrent injuries in schoolchildren
W. T. Boyce and S. Sobolewski
Department of Pediatrics, University of California, San Francisco 94143.
Past work identifying "accident-prone" children with disproportionate rates
of injury has been based on clinical data gathered in office, clinic, or
emergency department settings. To avoid the biases inherent in such
designs, we studied recurrent injuries in a school district population,
utilizing a prospective surveillance system to identify injuries meeting
standardized criteria. During three school years we observed 54,874
students, ranging in age from 6 to 18 years, for recurrent injuries, which
were defined as those occurring in a year in which two or more injuries
were reported for the child. Five hundred seventy-three recurrently injured
children (1% of the school district population) sustained 1405 injuries
(17% of the overall injury experience), a proportion significantly but only
slightly greater than that expected on the basis of chance alone (14%).
Most recurrently injured children were injured in only a single year, with
only 15 children sustaining injuries in all three study years. Age, sex,
and type of school were significant correlates of recurrent injury rates,
with junior high school students, boys, and students attending schools with
alternative educational programs having the highest rates of injury
recurrence. The findings indicate that (1) a small group of schoolchildren
sustain a disproportionate share of the overall injury experience, (2) the
majority of recurrently injured children experience only transient periods
of enhanced injury risk, and (3) preventive strategies may benefit from
investigation of developmental and social environmental factors that alter
such risk.
