Table 3.

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
Roberts et al., 1996 [46]	descriptive study/Office for Population Censuses Surveys	children (0–15 y) England and Wales	deaths	rates by social class and cause; trends of mortality rates	1979–83 to 1989–92 Social class gradients in mortality: 21% and 2% decline in social classes IV and V (47.5 to 37.8/100,000 and 84.7 to 82.9/100,000); 32% and 37% decline in social classes I and II (24.2 to 16.5/100,000 and 25.0 to 15.8/100,000)	Data on death only; missing data for 1981
DiGuiseppi et al., 1997 [43]	descriptive study/Office for National Statistics	children (0–14 y) England and Wales	deaths	proportions and trends of rates per mile travelled by age, gender, type road user	Travel patterns responsible for (34%) decline in children rates 1985–1992; declines in walking/cycling activities (37% and 38% declines pedestrian/cyclist rates)	Data on deaths only, focused on road traffic injuries; no population based rates for all injuries
Edwards et al., 2006 [41]	descriptive study/Office for National Statistics	children (0–15 y) England and Wales	deaths	rates and proportions by socio-economic classes, year, 3 y average, cause	1979–2003 Decline in death rates (per 100,000) from 11.1 (1979,1980, 1982) to 4.0 (2001–2003). Socio-economic gradients e.g. 13.1 times higher all external causes injury rates NSSEC* class 8 vs.1	Data on deaths only; lack of 1980 injury deaths data
Lyons et al., 1995 [57]	descriptive study/West Glamorgan injury database	children (0–14 y)/370000 West Glamorgan County, Wales	A&E	proportions by place; rates and correlation of distance to A&E, no car and Townsend with rate ratio	1993 18200 injuries/100,000 Association of overall and home injury with proximity to A&E unit; no association of injury with socioeconomic status	Fractures as a proxy indicator for severe injuries – Nuffield Hospital Classification 1 year study
Graham et al., 2004 [52]	descriptive (prospective) study/Crosshouse Hospital questionnaire data; Procurator Fiscal	children (0–13 y)/10697 Kilmarnock, Scotland	deaths, hospitalization and A&E	proportions by type; rates of admissions by age	1999/2000 5.6 hospital admissions per day Information on local injury data and preventive measures in use (cycle helmets used in 26% of cycle incidents; adult supervision in 49% of incidents)	No population based rates, no information on severity; 12.9% response rate
MacInnes & Stone 2008 [54]	descriptive study/Royal Hospital Sick Children database	children (<7 y) Glasgow, Scotland	A&E	proportions by age, gender, location, circumstances, cause, type of injury; rates by age, gender, location	1997–2001 14400/100,000 per year A&E attendance rate, peak values within 12–35 months; leading causes and types: 41% falls; 68% home location; 62% play related; 52% head injuries.	No information on severity; one geographical region only
Ness et al., 2002 [58]	descriptive survey/Glasgow Royal Infirmary Questionnaire data	children (13 y)/1493 Glasgow, Scotland	A&E	proportions by age, postcode – deprivation (Carstair Depcat)	1990 injuries by type, location (facial laceration, radius/ulna fractures most frequently; 72% outside house); most of injured children come from highest area of deprivation	53%questionnaire response rate; selection 10% of the questionnaires for analysis; study period – 3 months

* National Statistics Socio-Economic Classification (NSSEC) is a new, occupational based classification that replaced starting with 2001 the social classes. The analytic eight class version is described as follows: 1 higher managerial and professional occupations, 2 lower managerial and professional occupations, 3 intermediate occupations, 4 small employers and own account workers, 5 lower supervisory and technical occupations, 6 semi-routine occupations, 7 routine occupations, 8 never worked, long term unemployed [41]