Research Articles
The incidence of school-related injuries among adolescents in Kaohsiung, Taiwan

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Abstract

Objectives: To determine the incidence of nonfatal school-related injuries in adolescent schoolchildren.

Design: Nurses completed a Student Accident Report Form (SARF) on all injuries in schools meeting standardized criteria from September 1995 to June 1996.

Setting: Six junior high schools in Kaohsiung city, Taiwan.

Subjects: 13,335 adolescents aged 13–15 in six schools.

Results: A total of 3,640 injuries were reported among the city’s 13,335 students, for an overall injury rate of 27.3 injuries/100 student years. Injury rates were higher for boys than for girls at all grade levels. The seventh-grade students had the highest incidence rate. Injuries not involving other students accounted for nearly 64% of all injuries. Injuries occurring on the playground/gymnasium and classroom were the two most common types and were more than twice as frequent as injuries occurring in the hall or stairs. Contusions, abrasions, and swelling were the most frequently reported types of injuries. The body sites most frequently injured were the extremities. When exposure time is taken into account, injury rates were higher in the unsupervised areas of the schools.

Conclusions: School-related injury incidence among adolescents attending junior high school is higher than has been previously reported and should be recognized as a significant public health problem in Taiwan.

Introduction

Several previous studies have examined the epidemiology of school-related injuries to students.1, 2, 3, 4, 5, 6, 7, 8 Injuries to adolescents have an important social and economic impact on health care costs, lost school time, lost work time for parents, and rehabitation costs. Also, evidence shows that injury rates are highest for adolescents.9 Since injury prevention in a centralized location such as a school may be relatively economical, research into the number and types of injuries occurring in the schools, and during school-related activities, could have practical benefits.

According to the Department of Health in Taipei, Taiwan,10 injuries are the leading cause of mortality for children aged 1 to 19 years. Little research, however, has been conducted concerning nonfatal childhood injuries in Taiwan.11, 12 Accurate knowledge about school-related injuries is necessary if their number or severity is to be reduced. Under a grant from the National Science Council, the Kaohsiung Junior High School Injury Surveillance Project was developed. This paper provides descriptive epidemiologic analyses of the incidence of nonfatal school-related injuries occurring among 13,335 Kaohsiung adolescents aged 13 to 15 years during the academic year between September 1995 and June 1996.

Section snippets

Materials and methods

Kaohsiung is the second largest city in Taiwan, with 35 public junior high schools and nearly 78,000 students. Student enrollment in individual schools ranged from 506 to 4,969 students, with a mean of 2,236 students per school. This study was conducted using a sample of six randomly selected schools representing 13,335 students (17.1%) of the junior high school population. All six school principals agreed to participate in this research.

In order to determine the most efficient and effective

Results

During the study period, 3,640 injuries were reported among the 13,335 students, yielding an overall incidence rate of 27.3 per 100 students per student year. Two hundred and ten students sustained more than one injury, and 50 were injured three or more times. A total of 569 injuries, or 15.6% of all injuries, was sustained by students with recurrent injuries.

Table 1 shows the incidence of injuries by gender and grade level. The seventh-grade students had the highest incidence rate

Discussion

This paper, describing injury surveillance data for one school year in Kaohsiung, is the largest and most comprehensive study to date of adolescent school-related injuries in Taiwan. The overall rate of injuries in this study, 27.3 per 100 students, appears high in comparison with previously reported rates, which ranged from 1.7 to 9.22 per 100 students.1, 2, 3, 4, 5 The most likely reason is that previous studies limited their studies to injuries that were at least modestly serious. Our study,

Acknowledgements

This study was supported by a grant from the National Science Council, Executive Yuan, Taiwan (NSC-85-2331-B-037-062).

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Copyright © 1998 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.