Table 3 Epidemiological studies from the UK – childhood injuries
Author and date | Type of study/data source | Population (denominator)/size | Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
|---|---|---|---|---|---|---|
Roberts et al., 1996 [46] | descriptive study/Office for Population Censuses Surveys | children (0–15 y) England and Wales | deaths | rates by social class and cause; trends of mortality rates | 1979–83 to 1989–92 Social class gradients in mortality: 21% and 2% decline in social classes IV and V (47.5 to 37.8/100,000 and 84.7 to 82.9/100,000); 32% and 37% decline in social classes I and II (24.2 to 16.5/100,000 and 25.0 to 15.8/100,000) | Data on death only; missing data for 1981 |
DiGuiseppi et al., 1997 [43] | descriptive study/Office for National Statistics | children (0–14 y) England and Wales | deaths | proportions and trends of rates per mile travelled by age, gender, type road user | Travel patterns responsible for (34%) decline in children rates 1985–1992; declines in walking/cycling activities (37% and 38% declines pedestrian/cyclist rates) | Data on deaths only, focused on road traffic injuries; no population based rates for all injuries |
Edwards et al., 2006 [41] | descriptive study/Office for National Statistics | children (0–15 y) England and Wales | deaths | rates and proportions by socio-economic classes, year, 3 y average, cause | 1979–2003 Decline in death rates (per 100,000) from 11.1 (1979,1980, 1982) to 4.0 (2001–2003). Socio-economic gradients e.g. 13.1 times higher all external causes injury rates NSSEC* class 8 vs.1 | Data on deaths only; lack of 1980 injury deaths data |
Lyons et al., 1995 [57] | descriptive study/West Glamorgan injury database | children (0–14 y)/370000 West Glamorgan County, Wales | A&E | proportions by place; rates and correlation of distance to A&E, no car and Townsend with rate ratio | 1993 18200 injuries/100,000 Association of overall and home injury with proximity to A&E unit; no association of injury with socioeconomic status | Fractures as a proxy indicator for severe injuries – Nuffield Hospital Classification 1 year study |
Graham et al., 2004 [52] | descriptive (prospective) study/Crosshouse Hospital questionnaire data; Procurator Fiscal | children (0–13 y)/10697 Kilmarnock, Scotland | deaths, hospitalization and A&E | proportions by type; rates of admissions by age | 1999/2000 5.6 hospital admissions per day Information on local injury data and preventive measures in use (cycle helmets used in 26% of cycle incidents; adult supervision in 49% of incidents) | No population based rates, no information on severity; 12.9% response rate |
MacInnes & Stone 2008 [54] | descriptive study/Royal Hospital Sick Children database | children (<7 y) Glasgow, Scotland | A&E | proportions by age, gender, location, circumstances, cause, type of injury; rates by age, gender, location | 1997–2001 14400/100,000 per year A&E attendance rate, peak values within 12–35 months; leading causes and types: 41% falls; 68% home location; 62% play related; 52% head injuries. | No information on severity; one geographical region only |
Ness et al., 2002 [58] | descriptive survey/Glasgow Royal Infirmary Questionnaire data | children (13 y)/1493 Glasgow, Scotland | A&E | proportions by age, postcode – deprivation (Carstair Depcat) | 1990 injuries by type, location (facial laceration, radius/ulna fractures most frequently; 72% outside house); most of injured children come from highest area of deprivation | 53%questionnaire response rate; selection 10% of the questionnaires for analysis; study period – 3 months |