Temporal trends in unintentional injuries among Canadian children, 1994-2003

Abstract

Problem: Unintentional injuries are one of the leading threats to the well being of children. Epidemiological data is essential to understand the nature of the problem and to inform potential intervention efforts. The aim of this study was 1) to describe the changes in unintentional injury related deaths and hospitalisations among Canadian children over a ten year period and 2) to compare the trends over time with all cause mortality and morbidity. Methods: Data was obtained pertaining to unintentional injury related fatalities and hospital admissions for children aged 19 years and under for the years 1994 - 2003 from Statistics Canada and the Canadian Institute of Health Information. Results: Between 1994 and 2003, 8928 Canadian children aged 0-19 years died and 361800 were admitted to hospital because of an unintentional injury. The overall incidence rate was 1.14 (95% CI = 1.07-1.22) per 10 000 for deaths and 46.3 (95% CI = 44.9-47.9) per 10 000 for non-fatal hospitalisations. Temporal trends indicated a significant decline of approximately 2.7% per annum for fatalities while hospital admissions decreased annually by 3.5%. These decreases were slightly lower than those for all cause mortality (2.9%) and hospital admission (3.7%). During this period the mean length of stay decreased for non-fatal hospital admissions from 3.75 days in 1994 to 3.20 days in 2003. The proportion of hospital admissions that remained in hospital for over seven days also decreased from 9.8% in 1994 to 7.9% in 2003 (p<0.001). Conclusion: There has been a significant decline in unintentional paediatric injury related deaths and hospitalisations in Canada over a ten year period. The evidence suggests that the severity of injury occurring over this time also decreased resulting in shorter overall hospital stays. However, this decline is not an indication that the injury problem is being eliminated entirely, especially as the decrease does not exceed all cause fatality and hospitalisation rates among Canadian children