Table 2.
Epidemiological studies from the UK – childhood injuries
| Author and date | Type of study/data source |
Population (denominator)/size |
Level of severity | Epidemiological observation | Major findings | Epidemiological shortcomings |
| Walsh et al., 1996 [50] | descriptive (prospective) study/Coroner's files; Hospital data | children (0–16 y)/54400 Newcastle upon Tyne, England |
deaths, hospitalization and A&E | proportions, rates by severity (ISS), type, cause; correlation A&E rates and Townsend score | 1990 6 deaths: 904 admissions: 11682 A&E (1660/21490 per 100,000 admission/attendance rate); some associations of hospitalisations and A&E with deprivation |
1 year study and one geographical region. |
| Walsh & Jarvis, 1992 [55] | descriptive (retrospective) study/Office for Population Censuses Surveys; Northern Regional Health Authority | sample children (0–16 y)/153000 Northern Region England |
deaths, hospitalization | proportions by type, cause; rates by severity (ISS), age, ward; correlation of rates by census ward, severity | 1980–1986 Relationship of injury admission rates, deaths and severity with deprivation, e.g. relative rate of deprived vs. affluent areas 2.4 (all injuries); 3.6 (severe injuries) Highlights of the value of ISS methodology in epidemiological analysis |
96.4% of the hospitals admissions identified. |
| Armstrong & Robson, 1992 [47] | descriptive study/Liverpool Coroner's Office data | children (0–16 y) Liverpool, England |
deaths | proportions by cause, circumstances | Highlights areas of prevention: 60% pedestrian RTC (1978–1987) – half pedestrians struck by vehicles | No population based rates; data on deaths only; one region |
| Hippisley-Cox et al., 2002 [56] |
cross sectional survey/Trent NHS regional admissions database | children (0–14 y) Trent Region, England |
hospitalization | proportions by cause, age; rates by age, severity and deprivation; rate ratios for hospitals admissions | 1992–1997 socioeconomic gradients (particularly children under 5 y); adjusted rate ratio (fifth highest and lowest category by Townsend scores): 3.65 pedestrian; 3.49 burns & scalds | Data on severity based on health services use; one geographical region only |
| Laing & Logan, 1999 [53] | descriptive study/A&E King's College, St Thomas's, Guy's hospitals registries |
children (0–14 y) South-East London, England |
A&E | proportions and rates by age, gender, severity; correlation of Townsend score with A&E rates | 1992/1993 13820/100,000 annual attendance rate; socioeconomic gradients (even) within a disadvantaged population: a significant correlation between Townsend score and A&E attendance rate (p < 0.001) | 1 year study; 4 arbitrary categories of injury severity; codification – Home &Leisure Accident Surveillance |
| Edwards et al., 2008 [51] | descriptive study/Hospital Episodes Statistics | children (0–15 y) England |
hospitalization | rates and proportions by cause, rate ratio by socio-economic classes, location, index of multiple deprivation, regression (injury rates- census variables) | 1999–2004 1340/100,000 all injury rates 15.8/100,000 serious injury rate; falls account for 36% and 41% of all/serious admissions; socio-economic gradients for serious injuries, e.g. RR = 4.1 pedestrian i and RR = 3.0 cyclists most vs. least deprived areas | Serious injury defined by six ICD groups (S72.0, S06.1–.9, S14, S22.4, T71, T68) |
| Avery et al., 1990 [40] | descriptive study/Office for Population Censuses Surveys | children (0–14 y) England and Wales |
deaths | rates by geographical areas, trends and correlation of deprivation with deaths rates | 1975/1979 12.05/100,000; 1980/1984 10.33/100,000 geographical variations (higher urban vs. rural areas, NW vs. SE England); 1980–1984 socioeconomic gradients r = 0.56 for accidental deaths rate | Data on deaths only |