Introduction
Unintentional injuries are a growing global public health concern. As progress is made in addressing the risks associated with contagious and infectious childhood diseases, so injury has emerged as a major public health problem. Injury rates can vary considerably; between countries and between the communities within them. In the UK injury prevention efforts have had a considerable success and a downward trend in injury mortality is apparent; however persistent social inequalities continue to place poorer children at greater risk of injury than their more affluent counterparts.
Unintentional injury is a significant burden on the health services. Recent figures from Public Health England report 40,000 emergency hospital admissions each year for under-fives following unintentional injuries and a far greater number of attendances. At an individual level, children suffer pain associated with the original injury and with possible subsequent treatment, and run the risk of physical damage that may limit their long-term development. Certain injury events, such as road traffic accidents and house fires, potentially expose those involved to psychological trauma. Some families report increased emotional and financial stress following injury to a child. Severe injuries in children can result in considerable loss of schooling.
Global interest in addressing the injury burden has identified a range of proven and promising interventions. These are summarised in the World and European Reports on Child Injury Prevention. However, changes in social trends can create new injury hazards. For example, although the admission rates for medicinal poisoning in pre-school children in England decreased by 23% from 2000 to 2011, admissions from ingestion of soaps and detergents doubled over the same time frame. The introduction of liquitab washing detergents in 2001 may have played a role in this. Other examples of “new” injury risks that have been identified include burns from hair straighteners and poisoning from ingesting the contents of e-cigarettes.
Besides describing the public health importance of child injury prevention this article examines the risk factors associated with injuries. It discusses recent international and national guidance, together with recommended approaches to prevention. Crucially it highlights the key actions that paediatricians can contribute to child injury prevention.