presenting author: michal molcho

The epidemiology of non-fatal injuries among 11, 13, and 15 year old youth in

11 countries: findings from the 1998 WHO-HBSC study

The epidemiology of non-fatal injuries among 11, 13, and 15 year old youth in

11 countries: findings from the 1998 WHO-HBSC study

Presenting author:

Michal Molcho

Presenting author:

Michal Molcho

Reference: Molcho M., Harel Y., Pickett W. Schiedt P.C., Mazur J. Overpeck M.D. (2006). “The epidemiology of non fatal injuries among 11, 13 and 15 year old youth in 11 Countries: Findings from the 1998 WHO-HBSC cross national survey”. Injury Control and Safety Promotion (In press).

Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway

HBSC - background A cross-national research study conducted in

collaboration with the WHO Regional Office for Europe

HBSC was initiated in 1982 and is conducted every 4 years

HBSC 1998 involved more than 125,000 children from 29 countries

HBSC 2006 is expected to involve more than 180,000 children from 41 countries


HBSC 2006 – 41 regions


HBSC – some more background

The study aims to gain new insight into, and increase our understanding of young people's health and well-being, health behaviours and their social context


HBSC – topics covered

Demographics General health and well-being Family and peer relationships School environment Exercise and leisure time activities Substance use Violence and injuries Etc.


HBSC – some more background

The findings are used to inform and influence children’s policy and practice at national and international levels

The target age-groups are 11, 13 and 15 year olds attending school (n=4,500)

Sample sizes assured a 95% confidence interval of +/- 3% for prevalence estimates


Methodology - Data

1998 HBSC data from 11 countries: Belgium (Flemish sample), Canada, England, Hungary, Israel, Lithuania, Poland, Republic of Ireland, Sweden, Switzerland, and the USA

Sample of 52,955 schoolchildren


Methodology – Measures

Self reported medically attended injuries P12M

During the past 12 months, how many times were you injured, and had to be treated by a doctor or a nurse?



Measures of severity

Injury that resulted with one or more days missed from school or usual activities

Injury that resulted in two or more of the following treatments: placement of a cast, stitches, use of crutches and surgery; or injury that resulted with overnight hospitalization Measures of severity were collected in 8 of the 11

countries



Setting in which the injury occurred Where were you when this one most serious injury happened?

Activity during which the injury occurred

What were you doing when this one most serious injury happened?

FindingsFindings

International comparison of injuries

International comparison of injuries


Annual rates of medically attended injury and measures of severity per 100 by

country

50.4 50.3

47.4 47.445.5

42.2

39.037.8

35.7

29.9

24.1

9.4

5.6

12.412.2

14.6

18.1

23.9

18.7

15.3

30.6

20.0

6.8

12.9

8.08.7

10.38.0

6.05.8

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Israel Ireland USA Hungary Switzerland England Lithuania Canada Sweden Belgium(Flemish)

Poland

All Medically Treated Injuries

Injuries Resulting in Activity loss

Injuries Resulting in Serious Consequences


Medically attended injury: Cross-tabulation of injuries, by setting and activity context for all

11 countries combined

Home (or yard)

School Sport Facility/Field

Street Other Total

Biking 27.6 8.2 7.7 46.7 9.7 100.0

14.0 5.0 4.4 39.3 10.2 13.3

Sport Activity 12.9 31.2 47.9 2.6 5.3 100.0

16.5 47.9 68.5 5.5 14.1 33.5

Walking/Running 34.2 26.1 7.3 20.2 12.2 100.0

17.1 15.7 4.1 16.7 12.6 13.1

Other 41.6 18.3 7.0 7.2 25.9 100.0

39.8 21.0 7.5 11.4 51.3 25.1

Total 3,866 3,212 3,450 2,330 1,869 14,727

26.3 21.8 23.4 15.8 12.7 100.0


Country specific medically attended annual injury estimates by setting per 100 injured

persons

26.6

33.4

29.7

26.2

36.7

23.5

17.3

25.4

29.727.0

21.823.3

12.5

29.326.9

14.0

20.1

15.8

25.323.3 22.0 22.1

21.1

15.4

18.521.223.2

26.1

17.6

23.023.9

22.5

13.9

0.0

10.0

20.0

30.0

40.0

50.0

60.0Home (or home yard) School Sport Facility


Country variation in medically attended injury percentage from about 24% in Poland to about 50% in Israel

Striking consistency with respect to the locations and mechanisms

In all 11 countries boys experienced more injuries than girls

No clear age trend was found internationally

Main findings - prevalence


Country specific medically attended annual injury estimates by activity per 100 injured

persons

39.9

49.7

27.5

36.4

29.9

33.3

26.6

3.7 2.95.0

3.9 4.7

10.8

20.1

11.88.7

17.9

13.1

22.5

8.0

21.6

8.0

14.4

5.84.46.0

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Israel Ireland USA Hungary Lithuania Canada Sweden Belgium(Flemish)

Poland

Sport Activity Biking Fighting


High rates of bicycle relates injuries in Hungary (21.6%) and lower rates in Sweden, Canada and the US (11.8%, 8.0% and 8.0% respectively).

Klein et al.(2005) reported the relative lack of programs on bicycle safety for Hungary and more programs for Sweden, Canada and the US that corresponded with the percentages of school children using bicycle helmets in these countries

This may suggest that informed legislation and other injury prevention programs can play an important role in decreasing injury rates at the national level

Main findings – bicycle injuries


Cross-tabulation of severe injury rates by activity and type of severity measure for all

countries combined

Type of activity Activity loss Consequences

N % N %

Biking 1,913 13.0 1,947 14.8

Skating 1,131 7.5 1,157 9.1

Sport Activity 4,691 31.6 4,798 27.5

Riding in a Car 423 2.8 428 4.6

Walking/Running 1,771 11.7 1,835 12.7

Fighting 548 3.8 109 3.8

Other 3,462 29.7 3,513 27.6

Total 13,904 100.0 14,234 100.0


Overall, about 4% of all reported injuries were caused by fighting and this figure was consistent across the 11 countries

injuries due to fighting were responsible for only about 4% of all severe injuries, based upon both measures of severity used

Main findings – fighting

ConclusionsConclusions

So what have we learned?So what have we learned?


The high rates of injury among youth, in all 11 countries that collected these data in the WHO HBSC study indicate the universality of this problem

The cross-national similarities in locations are compelling

The three leading locations: home, school and sport facilities should be targeted as a high priority worldwide

Conclusions


The HBSC study does not provide in-depth information on injuries

data were collected during school class period. Thus, youth who were not in attendance at school were not represented

The study also relies upon self-reports and this involves use of individual students’ perceptions

Limitations


Mazur J., Scheidt P.C., Overpeck M.D., Harel Y., Molcho M. (2001). "Adolescents injuries in relation to economic status: An International perspective". Journal of Injury Control and Safety Promotion, 8(3) 179-182.

Pickett W., Garner M.J., Boyce W.F. and King M.A.(2002) “Gradients in risk for youth injury associated with multiple-risk behaviours: a study of 11,329 Canadian adolescents”. Social Science and Medicine, 55(6):1055-68.

Pickett W.; Schmid H.; Boyce W.F.; Simpson K.; Scheidt P.C.; Mazur J.; Molcho M.; King M.A..; Godeau E.; Overpeck M.; Aszmann A.; Szabo M.; Harel Y. (2002). "Multiple risk behavior and injury: an international analysis of young people". Archives of Pediatrics and Adolescent Medicine, 156:786-793

More “injury” papers from the HBSC


Pickett W, Molcho M, Simpson K, Janssen I, Kuntsche E, Mazur L, Harel Y, and Boyce WF (2005). “Cross-national study of injury and social determinants in adolescents”. Injury Prevention, 11:213-218.

Klein, K.S.; Thompson, D.; Scheidt P.C.; Overpeck, M.D.; Gross, L.A. (2005). “Factors associated with bicycle helmet use among young adolescents in a multinational sample”. Injury Prevention, 000:1-7.

Pickett W., Craig W., Harel Y., Cunningham J., Simpson K., Molcho M., Mazur J., Dostaler S. and Currie C.E. (2005). “Cross-national study of fighting and weapon carrying as determinants of adolescent injury”. Pediatrics 116(6):855-863.

More “injury” papers from the HBSC

presenting author: michal molcho

Documents

serious injury

injury control

europe hbsc

usual activities injury

hbsc studypresenting

activity context

hbsc cross national

activity lossinjuries