The epidemiology of injuries among elementary and middle school students in Shanghai from 2011 to 2015 academic year

Objective To investigate the epidemiology of injuries among elementary and middle school students in Shanghai, so as to provide basis for developing intervention strategies to reduce injuries for school-aged children.Methods Illness-induced absenteeism surveillance system was utilized to record injuries among school-aged students in Shanghai from 2011 to 2015 academic year. Epidemiological characteristics of injuries were analyzed.Results A total of 26 061 injury cases were reported from September 2011 to June 2016, most of which had only one single type (97.1%). Among all the identified cases, 71.3% involved boys, over 90% were about children whose age were between 6 and 10 years (41.8%) or between 11 and 15 years (48.8%). Over half of the cases occurred in April, May, September and October (54.7%). Freshmen in primary school, junior middle school, and senior middle school were all at higher risks compared to their counterparts in other school years. Fractures (48.1%), sprains/pulls (19.7%) and abrasions/contusions (15.0%) were the most common types of injuries. There were significant differences in the distribution of each injury type associated with gender (χ²=193.474, P<0.001), study stage (χ²=1 349.245, P<0.001) and month (χ²=290.992, P<0.001). The percentages of males with fractures (49.8% vs. 44.0%), and open wounds/hemorrhages (9.6% vs. 7.8%) exceeded those of females, while females were more likely to have sprains/pulls (22.0% vs. 18.7%), and bruises/contusions (16.1% vs. 14.4%). On the one hand, as students entered a higher grade, the proportions of fractures, bruises/contusions, open wounds/hemorrhages, scalds and crush injuries all decreased; whereas the proportions of sprains/pulls and muscle/tendon strain increased. On the other hand, the composition ratio of traumatic brain injury remained a steady level around 1.3% regardless of grade level.Conclusions Elementary and primary school students experienced different types of injuries, whose distribution varied with gender, grade level and month of the year. Health education and other preventive strategies should be implemented appropriately.