School entrance examinations as a small-scale data source for health monitoring of children using obesity as an example

Background: In the scope of the nationwide obligatory school entrance examinations (SEE), a standardised assessment of the preparedness for school of preschool children takes place in the federal states of Germany. For this purpose, height and weight of the children are determined. These data are available in aggregated form at county level, but are not yet being regularly compiled and processed at national level for use in policy and research. Methods: In a pilot project, the indexing and merging of SEE data from 2015–2019 was tested in collaboration with six federal states. This was done using obesity prevalence at the time of the school entrance examination. In addition, prevalences were linked to small-scale indicators on settlement structure and sociodemographics from public databases, differences in obesity prevalence at county level were identified, and correlations to regional influencing factors were visualised. Results: It was feasible to merge SEE data from the federal states with little effort. The majority of the selected indicators were freely available in public databases. In an interactive, easily comprehensible and user-friendly Tableau dashboard for visualising the SEE data, it can be seen that obesity prevalences differ significantly between counties that are similar in terms of settlement structure or sociodemographics. Conclusions: Providing federal state SEE data and linking them to small-scale indicators enables region-based analyses and cross-state comparisons of similar counties and provides a data basis for continuous monitoring of the prevalence of obesity in early childhood

Faktenblatt zu GEDA 2012: Ergebnisse der Studie: »Gesundheit in Deutschland aktuell 2012« - Arbeitsunfälle in Deutschland

Für die medizinische Behandlung von Verletzungen werden jährlich knapp 5 % der gesamten Krankheitskosten aufgewendet (ICD-10: S00 – T98) [Statistisches Bundesamt 2010]. 8,6 Millionen Menschen verletzten sich im Jahr 2013 durch Unfälle, so Schätzungen der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin. Darunter waren etwa eine Million meldepflichtige Unfälle am Arbeitsplatz [Bundesanstalt für Arbeitsschutz und Arbeitsmedizin 2013]. Das Unfallgeschehen in Deutschland lässt sich auf der Basis amtlicher Statistiken nur unvollständig abbilden. Ein Grund dafür ist, dass bedeutsame Bereiche nicht systematisch erfasst werden. So sind Arbeitsunfälle nur dann meldepflichtig, wenn Sie zu einer Arbeitsunfähigkeit von mehr als drei Tagen führen. Zudem können auf Basis der gemeldeten Arbeitsunfälle keine bevölkerungsbezogenen Prävalenzen berichtet werden [Bundesanstalt für Arbeitsschutz und Arbeitsmedizin 2014]. Repräsentative Befragungen liefern einen Überblick über das nichttödliche Unfallgeschehen [Robert Koch-Institut 2013; Varnaccia et al. 2014a] und sind daher eine wichtige Ergänzung für die Beschreibung des Arbeitsunfallgeschehens. Ausgewertet werden im Folgenden Daten der bevölkerungsrepräsentativen Befragung »Gesundheit in Deutschland aktuell« (GEDA) 2012

Population-Wide National Survey Data Emphasize the Importance of Work-Related Factors

Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand the occurrence of occupational injuries, sociodemographic factors and work- and health-related factors are tested simultaneously. Thus, the present analysis aims to develop a comprehensive epidemiological model that facilitates the explanation of varying injury rates in the workplace. The representative phone survey German Health Update 2010 provides information on medically treated occupational injuries sustained in the year prior to the interview. Data were collected on sociodemographics, occupation, working conditions, health-related behaviors, and chronic diseases. For the economically active population (18–70 years, n = 14,041), the 12-month prevalence of occupational injuries was calculated with a 95% confidence interval (CI). Blockwise multiple logistic regression was applied to successively include different groups of variables. Overall, 2.8% (95% CI 2.4–3.2) of the gainfully employed population report at least one occupational injury (women: 0.9%; 95% CI 0.7–1.2; men: 4.3%; 95% CI 3.7–5.0). In the fully adjusted model, male gender (OR 3.16) and age 18–29 (OR 1.54), as well as agricultural (OR 5.40), technical (OR 3.41), skilled service (OR 4.24) or manual (OR 5.12), and unskilled service (OR 3.13) or manual (OR 4.97) occupations are associated with higher chances of occupational injuries. The same holds for frequent stressors such as heavy carrying (OR 1.78), working in awkward postures (OR 1.46), environmental stress (OR 1.48), and working under pressure (OR 1.41). Among health-related variables, physical inactivity (OR 1.47) and obesity (OR 1.73) present a significantly higher chance of occupational injuries. While the odds for most work-related factors were as expected, the associations for health-related factors such as smoking, drinking, and chronic diseases were rather weak. In part, this may be due to context-specific factors such as safety and workplace regulations in high- income countries like Germany. This assumption could guide further research, taking a multi-level approach to international comparisons

Schuleingangsuntersuchungen als kleinräumige Datenquelle für ein Monitoring der Kindergesundheit am Beispiel Adipositas

Hintergrund: Im Rahmen der bundesweit verbindlichen Schuleingangsuntersuchungen (SEU) findet in den Ländern eine standardisierte Erfassung der Schulreife von Vorschulkindern statt. Dazu werden auch Körpergröße und -gewicht der Kinder bestimmt. Diese Daten liegen aggregiert auf Kreisebene vor, eine regelmäßige Zusammenführung und Aufbereitung auf Bundesebene zur Nutzung für Politik und Forschung erfolgt bisher nicht. Methode: In einem Pilotprojekt wurde in Zusammenarbeit mit sechs Ländern die Erschließung und Zusammenführung von SEU-Daten der Jahre 2015 – 2019 erprobt. Dies erfolgte am Beispiel der Adipositasprävalenz zum Zeitpunkt der Schuleingangsuntersuchung. Zusätzlich wurden die Prävalenzen mit kleinräumigen Indikatoren zu Siedlungsstruktur und Soziodemografie aus öffentlichen Datenbanken verknüpft, Unterschiede in der Adipositasverbreitung auf Kreisebene identifiziert und Zusammenhänge mit regionalen Einflussfaktoren visualisiert. Ergebnisse: Die Zusammenführung der SEU-Daten der Länder war mit geringem Aufwand möglich. Die Mehrheit der ausgewählten Indikatoren war frei in öffentlichen Datenbanken verfügbar. In einem interaktiven, leicht verständlichen und nutzungsfreundlichen Tableau-Dashboard zur Visualisierung der SEU-Daten kann abgelesen werden, dass sich die Adipositasprävalenzen deutlich zwischen siedlungsstrukturell oder soziodemografisch ähnlichen Kreisen unterscheiden. Schlussfolgerungen: Die Bereitstellung der SEU-Daten der Länder und die Verknüpfung mit kleinräumigen Indikatoren ermöglichen regionalisierte Analysen und länderübergreifende Vergleiche ähnlicher Kreise und stellen eine Datengrundlage für ein kontinuierliches Monitoring der Adipositasprävalenz im frühen Kindesalter dar

SARS-CoV-2 Transmissibility Within Day Care Centers—Study Protocol of a Prospective Analysis of Outbreaks in Germany

Introduction: Until today, the role of children in the transmission dynamics of SARS-CoV-2 and the development of the COVID-19 pandemic seems to be dynamic and is not finally resolved. The primary aim of this study is to investigate the transmission dynamics of SARS-CoV-2 in child day care centers and connected households as well as transmission-related indicators and clinical symptoms among children and adults. Methods and Analysis: COALA (“Corona outbreak-related examinations in day care centers”) is a day care center- and household-based study with a case-ascertained study design. Based on day care centers with at least one reported case of SARS-CoV-2, we include one- to six-year-old children and staff of the affected group in the day care center as well as their respective households. We visit each child's and adult's household. During the home visit we take from each household member a combined mouth and nose swab as well as a saliva sample for analysis of SARS-CoV-2-RNA by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) and a capillary blood sample for a retrospective assessment of an earlier SARS-CoV-2 infection. Furthermore, information on health status, socio-demographics and COVID-19 protective measures are collected via a short telephone interview in the subsequent days. In the following 12 days, household members (or parents for their children) self-collect the same respiratory samples as described above every 3 days and a stool sample for children once. COVID-19 symptoms are documented daily in a symptom diary. Approximately 35 days after testing the index case, every participant who tested positive for SARS-CoV-2 during the study is re-visited at home for another capillary blood sample and a standardized interview. The analysis includes secondary attack rates, by age of primary case, both in the day care center and in households, as well as viral shedding dynamics, including the beginning of shedding relative to symptom onset and viral clearance. Discussion: The results contribute to a better understanding of the epidemiological and virological transmission-related indicators of SARS-CoV-2 among young children, as compared to adults and the interplay between day care and households.Peer Reviewe

Possibilities for prevention reporting

The generally complex nature of interventions in disease prevention and health promotion pose particular challenges to establishing a system for prevention reporting. Comprehensive impact models and specific indicators that are capable of capturing risks as well as protective factors and also account for both behavioural and community factors should provide the basis. After health monitoring, we will also need to establish a system for the monitoring of interventions, policy and media

Das Unfallgeschehen bei Kindern und Jugendlichen in Deutschland

Kinder und Jugendliche haben im Vergleich zu Erwachsenen ein besonders hohes Risiko, Unfallverletzungen zu erleiden. Um Unfallverletzungen vorzubeugen, sind detaillierte Kenntnisse über das gesamte Unfallgeschehen und über die Determinanten von Unfallverletzungen notwendig. Dieser Artikel gibt einen Überblick über Daten zu Unfällen bei Kindern und Jugendlichen in Deutschland. Laut dem Kinder- und Jugendgesundheitssurvey (KiGGS-Basiserhebung) des Robert Koch-Instituts (RKI) erleiden in Deutschland etwa 15,3 % der Kinder und Jugendlichen (1 bis 17 Jahre) pro Jahr mindestens eine Unfallverletzung. Die meisten Unfälle (60,7 %) ereignen sich zu Hause oder bei Freizeitbeschäftigungen. In Bildungs- und Betreuungseinrichtungen registrierte die Deutsche Gesetzliche Unfallversicherung (DGUV) im Jahr 2011 über 1,4 Mio. Unfälle. Die amtliche Verkehrsunfallstatistik zählte im gleichen Jahr mehr als 50.000 minderjährige Verkehrsunfallopfer. Die Krankenhausdiagnosestatistik erfasste im Jahr 2011 insgesamt 260.534 stationäre Behandlungsfälle aufgrund von Verletzungen und Vergiftungen bei Kindern und Jugendlichen. Alters- und geschlechtsspezifische Unterschiede zeigen sich in allen Datenquellen. Jungen sind häufiger von Unfallverletzungen betroffen als Mädchen. Im Jugendalter erleiden sie mehr Unfälle als im Kleinkind- und Grundschulalter. Bei jungen Kindern ereignen sich Unfälle hauptsächlich zu Hause, bei Jugendlichen zunehmend im Verkehr oder bei Freizeitbeschäftigungen. Es gibt zahlreiche Initiativen in Deutschland, die sich der Prävention von Unfällen bei Kindern und Jugendlichen widmen. Die Ableitung zielgruppenspezifischer Präventionsmaßnahmen wird durch die unterschiedlichen methodischen Zugänge der verfügbaren Datenquellen erschwert.Compared to adults, children and adolescents run a considerably higher risk of suffering unintentional injuries (UI). To prevent UI, detailed knowledge of the overall accident occurrence and the determinants of UI is needed. This article gives an overview of the data sources covering the occurrence of UI among children and adolescents in Germany. According to the Robert Koch Institute’s German Health Interview and Examination Survey for Children and Adolescents (KiGGS), approximately 15.3 % of children and adolescents (1–17 years) in Germany suffer at least one UI within 12 months. Most accidents (60.7 %) occur at home or during leisure-time activities. In 2011, the German Statutory Accident Insurance (DGUV) registered more than 1.4 million accidents among children in day-care facilities and students in educational institutions. According to official statistics, in the same year, more than 50,000 children and adolescents were injured in traffic accidents. Moreover, the Federal Statistical Office registered 260,534 hospital admissions due to injuries and poisonings among children and adolescents. All data sources revealed age- and sex-specific differences. Boys suffer UI more frequently than girls do and they show higher injury rates in adolescence than during childhood. While UI among children mostly happen at home, road traffic and leisure-time accidents increase in occurrence during adolescence. In Germany, there are numerous initiatives dedicated to the prevention of UI in children and adolescents. The creation of target group-specific prevention measures is complicated by the fact that the methodological approaches of existing data sources differ considerably

Factors influencing childhood obesity – the establishment of a population-wide monitoring system in Germany

Obesity poses a danger to childhood health and can continue to have a negative impact on health into adulthood. Currently, about 15% of children and adolescents in Germany are overweight or obese. Moreover, significant data on the multifactorial causes of childhood obesity that is systematically recorded, regularly updated and obtainable at the nationwide level are not yet available in Germany. As such, the Robert Koch Institute is establishing a population-wide system to monitor the factors that are relevant to childhood obesity (AdiMon). AdiMon will be available by the end of 2017. This paper outlines the methodological approach that is being used to establish AdiMon and describes the current results of the project (the development of an initial set of core indicators). The project began by undertaking a systematic literature review aimed at piecing together the latest knowledge on factors that influence childhood obesity. The factors that were identified were then sorted according to relevance, and appropriate indicators were selected. This was followed up by research into data sources that – as far as possible – provide significant data that are regularly collected but that also provide for regional differentiation. Work is currently underway to analyse these indicators and data sources. Once this work has been completed, the indicator set will be finalised and the results published on the internet. Population-wide monitoring of factors relevant to childhood obesity takes the following types of indicators into account: behavioural factors (such as physical activity), biological factors (such as genetic predisposition), prenatal and early-childhood factors (such as breastfeeding), psychosocial factors (such as parents’ health consciousness), environmental factors (such as playgrounds in the local area), contextual factors (such as a migrant background) and prevention measures as well as measures to promote health (such as expenditure by statutory health insurers). The population-wide monitoring uses the following data sources: epidemiological studies, social sciences surveys, official statistics and geo-information systems, as well as routine, economic and media data. This paper demonstrates that population-wide monitoring can provide significant information about the distribution and causes of obesity in childhood, and thus enable the need for action to be recognised at an early stage, initial approaches for preventive measures to be identified and developments to be tracked over time