Unintentional child injuries are a major public health issue in Australia. Most can be prevented. Preventable injuries are higher amongst children compared with other age groups (ABS 2007).
In 2005–2006, 22,865 children 0–4 years of age were admitted to hospital for injury across Australia. This was second only to admissions to hospital for respiratory conditions. Hospital rates were higher for boys than girls. Hospitalisation rates for falls and poisonings were higher for children living in rural and remote communities, compared to children living in metropolitan areas (1.5 times greater for falls and 1.9 times greater for poisoning) (AIHW 2008).
More children die from injury in Australia (36%), than from cancer (19%) and diseases of the nervous system combined (11%) (ABS 2006).
The main causes of child deaths from unintentional injury are:
- Transport related (car crashes and driveway run-overs)
- Drowning (in particular swimming pools)
- Unsafe sleeping environments
- Strangulation/suffocation (entrapment, strangulation by curtain and blind cords)
- Crush injuries (large objects falling onto a child)
Success has been achieved in injury reduction in Australia in a number of areas, with the number of child deaths declining by approximately 60% since 1983 (AIHW 2005). This reduction provides evidence that dramatic success in reducing child death and injuries is possible through the use of multiple strategies. These have included legislative changes, environmental changes, community action, information, education and training. There is still much work to be done.
There is a strong association between age of a child, developmental stage, how the child interacts with their environment, the type of activities the child undertakes, socio-economic status, gender, and the type of injury the child sustains (WHO & UNICEF 2008).
Children 0–4 years of age are most vulnerable to being injured in the home and backyard. More than half of unintentional deaths and injuries in this age group occur in the home and backyard, with 55% of these inside the home and 45% in the backyard (Shannon, Brashaw, Lewis & Feldman 1992).
Heights, space, and structures are built for adult use and comfort, but these often present hazards to children (Safe Kids Canada 2006).
Hospitalisation of young children from unintentional injury is most commonly the result of: Falls (from nursery furniture, beds, chairs and in the backyard from playground equipment). Burns and scalds (from hot drinks and food, liquids, hot objects). Poisonings (from medicines, household cleaners, alcohol). Vehicle accidents (most young children who die, or are injured, were not properly restrained in the car). Near drowning (most commonly in backyard swimming pools). Dog bites (mostly by dogs known to the child in the home environment). Choking (food or small objects). Pedestrian injuries.
The interesting fact about child injury data, which reports on admission to hospital, is that the main causes of injury are consistent from year to year. However, hospital admission data only represents a small insight into the overall picture of unintentional childhood injury.
Injury is often represented as a pyramid. The smallest group, that of death, at the top; admission to hospital for injury in the middle; and the largest groups of non-hospitalised and those requiring first aid etc. at the base (WHO & UNICEF 2008).
The annual cost of unintentional injury and death to children 0–4 years of age in Australia is estimated to be 1.5 billion dollars (Moller 1998).
For specific causes of injury and death, the top five most costly among children under 5 in Victoria were: falls ($22m); poisoning ($12m); fire, flames, and burns ($8m); hit, struck, or crush injury ($7m); and motor vehicle traffic ($4m) (Watson & Ozanne Smith 1997). More recent figures are not available.