Fatal unintentional injuries among young children – A hospital based retrospective analysis

doi:10.1016/j.jflm.2008.12.017

Journal of Forensic and Legal Medicine

Volume 16, Issue 6, August 2009, Pages 307-311

https://doi.org/10.1016/j.jflm.2008.12.017 Get rights and content

Abstract

Unintentional (accidental) injuries in childhood constitute a significant public health problem. Young children are extremely vulnerable to unintentional injuries that are vastly preventable. All cases of fatal unintentional injuries in children aged 10 years and below autopsied during 1994–2007 were retrospectively reviewed. Seventy five such cases were identified during the 14 year study period. Males accounted for 68% of cases with a male–female ratio of 2.1:1. Mean age of male and female victims was 5.3 and 4.9 years, respectively. Road traffic fatalities accounted for majority of the cases in this age group (52%), followed by those due to thermal injuries (22.7%). Flame was the cause of thermal injuries in 52.9% cases and scalds were observed in 47.1% cases. Traffic fatalities, fall and drowning were more common in school age children while toddlers and pre-school age children were relatively at a greater risk from domestic accidents (thermal injuries and poisoning). The most frequent victims of road traffic incidents were pedestrians (64.1%). Head injuries alone were the cause of fatalities in the majority of road traffic incidents (82.1%). The study highlights on the pattern of fatalities due to unintentional injuries among young children. To reduce the burden of unintentional childhood mortalities in this region, priorities for school age children are traffic injuries and for toddlers and pre-school children, thermal injuries.

Introduction

Worldwide about 3.5 million people die of unintentional (accidental) injuries every year and 25% of the global accidental deaths are estimated to occur in the South East Asia region.[1], 2 Unintentional (accidental) injuries in childhood constitute a significant public health problem and have been considered as ‘the last major plague of the young’.³ Children in the first decade of life are extremely vulnerable and need adult care and guidance. They are exposed to both natural (medical) and unnatural (accidents, suicides or homicides) fatal conditions. Death attributable to medical conditions are likely to be considered preventable while deaths attributable to unintentional injuries are vastly preventable.

Kasturba hospital is the apex teaching hospital of Kasturba Medical College, Manipal situated in Udupi District of coastal Karnataka in southern India. The pattern of unnatural deaths in children and adolescents in this region has been previously addressed.⁴ A brief report on the problem status of accidental childhood fatalities⁵ has prompted the authors to take up this research in detail, with a comparison with studies done elsewhere in India and abroad. This hospital based retrospective study aims at a detailed description of the pattern and trend of accidental deaths in young children aged 10 years and below, in Manipal during 1994–2007, that may help in recognition of vulnerable groups for development of strategies to prevent such mortalities.

Section snippets

Material and methods

This study is a registry based detailed descriptive retrospective research that was carried out in the Department of Forensic Medicine, Kasturba Medical College, Manipal. All medicolegal autopsy case records from January 1994 to December 2007 were retrospectively reviewed and deaths among young children aged 10 years and below were analysed.

Medicolegal autopsies are performed as per the law of the land towards administration of justice. In India, manner of death in all cases of fatal

Results

In the 14 years (1994–2007), that the study spanned, 75 cases of fatal unintentional injuries were identified in children aged 10 years and below. This amounted to 3.4% of total cases autopsied (n = 2181) during the study period. Of the 75 fatalities, 68% victims (n = 51) were males and 32% (n = 24) were females. Overall male–female ratio was found to be 2.1:1. Mean age of male and female victims was 5.3 and 4.9 years, respectively. Although overall age distribution was fairly uniform, maximum

Discussion

The health problems encountered by the developing world pediatric population comprise mainly of low birth weight, malnutrition, infections, accidents and poisoning, whereas in the developed world, accidents and poisoning are a relatively more important health problem. The leading causes of death in the below 5 years age group in the developing countries are diarrhoea and respiratory infections followed by communicable diseases and accidents. In the developed world, however, unintentional

Conclusions

Unintentional (accidental) injury in young children is a significant problem. The study highlights the magnitude and pattern of mortalities from such injuries among young children in Manipal, Southern India:

•
Male children are recognized as the vulnerable group accounting for 69.3% of the total fatalities.
•
Road traffic injuries and thermal injuries together accounted for 72.5% fatalities in males and 79.1% fatalities in females.
•
Females were relatively more prone to thermal injuries and males to

Conflict of interest statement

The authors have no conflict of interest to declare.

Funding

No funding.

Ethical approval

None declare.

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^☆: Presented at the 2nd Asia Pacific Injury Prevention Conference at Hanoi, Vietnam (November 2008).

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Original CommunicationFatal unintentional injuries among young children – A hospital based retrospective analysis☆

Abstract

Introduction

Section snippets

Material and methods

Results

Discussion

Conclusions

Conflict of interest statement

Funding

Ethical approval

Zhonghua Yu Fang Yi Xue Za Zhi

Burns

Epidemiology of chronic non-communicable diseases and conditions

The hidden epidemic-war on roads

Indian J Crit Care Med

Child injury mortality in New Zealand 1986–95

J Paediatr Child Health

Mortalities among children and adolescents in Manipal, Southern India

J Trauma

Accidental childhood fatalities in Manipal, India

Trop Doct

Almost 19 million childhood injuries result in 11 thousand deaths

ASDC J Dent Child

Traumatic deaths in children: the importance of prevention

Med J Aust

Injury mortality and morbidity among children in the United Arab Emirates

Eur J Epidemiol

Severe and fatal childhood trauma

Injury

Injury fatalities among young children

Public Health Rep

Deaths from injury in childhood in Western Australia 1983–1992

Med J Aust

Childhood injury deaths: national analysis and geographical variations

Am J Public Health

Injury-related mortality in South African children, 1981–1985

South Afr Med J

Causes of fatal childhood accidents in North Staffordshire, 1980–1989

Arch Emerg Med

Original Communication
Fatal unintentional injuries among young children – A hospital based retrospective analysis☆