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. 2004 Jun;10(3):144–148. doi: 10.1136/ip.2003.005017

A population based investigation of head injuries and symptoms of concussion of children and adolescents in schools

B Willer 1, J Dumas 1, A Hutson 1, J Leddy 1
PMCID: PMC1730088  PMID: 15178669

Abstract

Objective: To examine the incidence of head injury and symptoms of concussion among children at school and to determine the relationship of age, gender, and cause to incidence rates.

Design: Incident reports involving head injury for schools in the Province of Ontario, Canada during the year 2000 were evaluated.

Participants: The population base for the schools represented was 1 372 979 children aged 6 to 16.

Setting: 95% of schools in the province of Ontario, Canada participated in the injury reporting system.

Main outcome measures: A head injury was defined as any injury to the head that came to the attention of a school official. Head injuries accompanied by symptoms of concussion became a secondary outcome measure.

Results: There were 11 068 unduplicated head injury reports for the year 2000 of which 1861 qualified as producing signs or symptoms of concussion. Young children were more likely to have a head injury than older children, but slightly less likely to experience concussive symptoms. The primary cause of injury to young children was falls. Older children were more likely to receive head injuries and symptoms of concussion from sports activities.

Conclusions: Overall rate of injury (3.98 per 100 children) was consistent with previous studies using prospective injury reporting systems. Probability of a head injury with symptoms of concussion among schoolchildren was only 1.9% for boys and <1% for girls during the course of their school years. There is ample justification for prevention efforts in schools.

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Selected References

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  1. Aubry M., Cantu R., Dvorak J., Graf-Baumann T., Johnston K., Kelly J., Lovell M., McCrory P., Meeuwisse W., Schamasch P. Summary and agreement statement of the First International Conference on Concussion in Sport, Vienna 2001. Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries. Br J Sports Med. 2002 Feb;36(1):6–10. doi: 10.1136/bjsm.36.1.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Body C., Leathem J. Incidence and aetiology of head injury in a New Zealand adolescent sample. Brain Inj. 1996 Aug;10(8):567–573. doi: 10.1080/026990596124133. [DOI] [PubMed] [Google Scholar]
  3. Boyce W. T., Sobolewski S. Recurrent injuries in schoolchildren. Am J Dis Child. 1989 Mar;143(3):338–342. doi: 10.1001/archpedi.1989.02150150096024. [DOI] [PubMed] [Google Scholar]
  4. Boyce W. T., Sprunger L. W., Sobolewski S., Schaefer C. Epidemiology of injuries in a large, urban school district. Pediatrics. 1984 Sep;74(3):342–349. [PubMed] [Google Scholar]
  5. Deb Shoumitro, Crownshaw Tina. The role of pharmacotherapy in the management of behaviour disorders in traumatic brain injury patients. Brain Inj. 2004 Jan;18(1):1–31. doi: 10.1080/0269905031000110463. [DOI] [PubMed] [Google Scholar]
  6. Erlanger David, Kaushik Tanya, Cantu Robert, Barth Jeffrey T., Broshek Donna K., Freeman Jason R., Webbe Frank M. Symptom-based assessment of the severity of a concussion. J Neurosurg. 2003 Mar;98(3):477–484. doi: 10.3171/jns.2003.98.3.0477. [DOI] [PubMed] [Google Scholar]
  7. Field Melvin, Collins Michael W., Lovell Mark R., Maroon Joseph. Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. J Pediatr. 2003 May;142(5):546–553. doi: 10.1067/mpd.2003.190. [DOI] [PubMed] [Google Scholar]
  8. Glor E. D. Survey of comprehensive accident and injury experience of high school students in Saskatchewan. Can J Public Health. 1989 Nov-Dec;80(6):435–440. [PubMed] [Google Scholar]
  9. Guskiewicz Kevin M., McCrea Michael, Marshall Stephen W., Cantu Robert C., Randolph Christopher, Barr William, Onate James A., Kelly James P. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA. 2003 Nov 19;290(19):2549–2555. doi: 10.1001/jama.290.19.2549. [DOI] [PubMed] [Google Scholar]
  10. Hammarström A., Janlert U. Epidemiology of school injuries in the northern part of Sweden. Scand J Soc Med. 1994 Jun;22(2):120–126. doi: 10.1177/140349489402200207. [DOI] [PubMed] [Google Scholar]
  11. Junkins E. P., Jr, Knight S., Lightfoot A. C., Cazier C. F., Dean J. M., Corneli H. M. Epidemiology of school injuries in Utah: a population-based study. J Sch Health. 1999 Dec;69(10):409–412. doi: 10.1111/j.1746-1561.1999.tb06360.x. [DOI] [PubMed] [Google Scholar]
  12. Kelly J. P., Rosenberg J. H. Diagnosis and management of concussion in sports. Neurology. 1997 Mar;48(3):575–580. doi: 10.1212/wnl.48.3.575. [DOI] [PubMed] [Google Scholar]
  13. Lenaway D. D., Ambler A. G., Beaudoin D. E. The epidemiology of school-related injuries: new perspectives. Am J Prev Med. 1992 May-Jun;8(3):193–198. [PubMed] [Google Scholar]
  14. Lovell Mark R., Collins Michael W., Iverson Grant L., Johnston Karen M., Bradley James P. Grade 1 or "ding" concussions in high school athletes. Am J Sports Med. 2004 Jan-Feb;32(1):47–54. doi: 10.1177/0363546503260723. [DOI] [PubMed] [Google Scholar]
  15. McKeag Douglas B. Understanding sports-related concussion: coming into focus but still fuzzy. JAMA. 2003 Nov 19;290(19):2604–2605. doi: 10.1001/jama.290.19.2604. [DOI] [PubMed] [Google Scholar]
  16. Schuller A. A., Kopjar B. Skader oppstått på skolen hos barn mellom sju og 15 år. Tidsskr Nor Laegeforen. 2000 Jan 30;120(3):301–305. [PubMed] [Google Scholar]
  17. Segalowitz S. J., Brown D. Mild head injury as a source of developmental disabilities. J Learn Disabil. 1991 Nov;24(9):551–559. doi: 10.1177/002221949102400907. [DOI] [PubMed] [Google Scholar]
  18. Segalowitz S. J., Lawson S. Subtle symptoms associated with self-reported mild head injury. J Learn Disabil. 1995 May;28(5):309–319. doi: 10.1177/002221949502800507. [DOI] [PubMed] [Google Scholar]
  19. Sheps S. B., Evans G. D. Epidemiology of school injuries: a 2-year experience in a municipal health department. Pediatrics. 1987 Jan;79(1):69–75. [PubMed] [Google Scholar]
  20. Thurman D. J., Branche C. M., Sniezek J. E. The epidemiology of sports-related traumatic brain injuries in the United States: recent developments. J Head Trauma Rehabil. 1998 Apr;13(2):1–8. doi: 10.1097/00001199-199804000-00003. [DOI] [PubMed] [Google Scholar]

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