Home injury patterns in children: A comparison by hospital sites

Abstract

BACKGROUND: Many intervention studies typically require data from several centres to ensure adequate power. The usual intention is to pool data after testing for heterogeneity. Sites that differ in sample characteristics may, on the one hand, complicate the assessment of the intervention, but on the other hand, they may add important insights through analysis of site-specific findings. OBJECTIVES: The aims of the present paper were to compare the distribution of injuries and risk factors among children participating in a five-centre study of a home-based injury prevention program, and to contrast parental injury awareness and knowledge with home safety measures. METHODS: Five children's hospitals in Canada agreed to participate in a case-control study combined with a randomized controlled trial. Patients were children zero to seven years of age presenting to a hospital emergency department with a fall, burn, ingestion or choking. Two controls were matched to each case, one with another injury and another with a minor illness. A home visitor completed a home hazard assessment based on observed safety measures. To determine whether data could be pooled, comparisons across sites were made with respect to types of injuries seen, sociodemographic characteristics, observed hazards and the parents' reported beliefs about severity of injuries, safety measures, preventability of injuries and susceptibility to injuries. RESULTS: There were few differences between the five hospitals. The mean age was 2.2 years (range 1.4 to 3.3). There were 219 falls (56%), 80 burns (20.4%), 54 poisonings (13.8%), and 38 chokings (9.7%), all distributed in a proportionately similar manner, except for poisoning, at each site. There were significantly more well-educated fathers at one hospital and younger parents with less education at another. Homes were generally lacking five recommended safety measures. However, most parents at all sites perceived their home as being very safe for any of the specific injuries, and their child as being at low risk of sustaining any of these injuries. CONCLUSIONS: The similarity across sites supports the pooling of these data regarding hospital-treated injuries in young children in urban Canada. Most parents at all sites perceived their home as being very safe in spite of their homes lacking one-quarter of the recommended safety measures. This discrepancy between parental perception and home safety highlights the needs for further education and prevention efforts.