Trends and future projections of child injury in New South Wales : A tool for advocacy?

AIMS: To describe the trend of unintentional hospitalised injury in children aged 0-14 years in New South Wales (NSW), Australia during 1993-1994 to 2004-2005 and to estimate future projections of common child injury hospitalisations from 2006 to 2021. METHODS: NSW hospitalisation data were used to describe injury trends of children aged 14 years or less who were residents of NSW (1993-1994 to 2004-2005). Projected injury-related hospitalisations of children for 2006-2021 were estimated assuming that the current observed rate of change in childhood injury hospitalisation rates continued to 2021. RESULTS: During 1993-1994 to 2004-2005, there were 238 093 injury-related hospitalisations of children aged 14 years or less in NSW. Assuming the rate of change in injury hospitalisation observed between 1993-1994 and 2004-2005 continued into the future, the all hospitalised injury incidence rate for children aged 14 years or less is projected to decrease by 1.0% each year to 2021. Injury mechanisms such as burns and scalds, swimming pool non-fatal drowning and poisoning are all projected to decrease in the future, although not for all age groups. Falls (excluding those from playground equipment) and falls from playground equipment hospitalisations (excluding children less than 1 year) are projected to increase. CONCLUSION: Although the incidence of hospitalisation for some common child-related injury mechanisms is projected to decrease over the coming years, others are projected to increase. It is possible that advocacy efforts might benefit from using projected injury trends. Co-ordinated cross-government action is needed to successfully implement child injury prevention strategies, particularly in the playground environment.8 page(s

Unintentional Poisoning in Young Children: Identification of Risk Factors

Unintentional childhood poisoning is an important public health issue. Children aged 0-4 years are often analysed together as a group for unintentional poisoning risk for statistical purposes. However, these children are quite different in terms of their physical, cognitive and self-regulatory abilities. This thesis examines the contribution of child development to poisoning risk Three population-based epidemiology studies were conducted that used age as a proxy for development and controlled for other variables that might be contributing to a young child's poisoning risk. The findings of the three age pattern studies demonstrated strong support for the contribution of child development to poisoning events. Children aged 1-3 years had the highest level of risk in all three studies and the age patterns remained stable when analysed over time and by sex, socio-economic status and remoteness of residence. These findings warranted further investigation of child development as a risk factor for unintentional poisoning in children aged 1-3 years.A case-control study was designed to investigate child development and other potential risk factors for unintentional poisoning. It employed three control groups, injured, sick and healthy, to indentify risk factors specific to unintentional poisoning. Both questionnaire and observational measures were used to assess the factors. The importance of age and the role of development in unintentional poisoning risk were highlighted by the findings of the risk factor study. Several variables were identified as contributors to poisoning events which also may reflect a younger poisoning group. The study indicated that maternal use of more positive control, accessible poison storage locations and less parenting stress all contributed to unintentional poisoning. Less close supervision was also identified as a risk factor, indicating that proximity of supervision may be important for poison prevention. The findings of these four studies demonstrated that development plays a major role in unintentional poisoning risk for children aged 1-3 years. Taken together, information regarding age patterns and risk factors for unintentional poisoning in young children may help target prevention measures and identify areas warranting further research