Background School injuries are recognized as a preventable public health problem. No study has been conducted to find the incidence of school injuries in Sri Lankan schools up to date.

Methods A sample of 820 students were recruited using multi-stage cluster sampling from an education division in Kandy. A well-structured, pre-tested, interviewer-administered questionnaire was used to gather information on unintentional school injuries that took place in the preceding 1 month. Injury severity was assessed using the Abbreviated Injury Score (AIS). The statistical significance of the associations was tested using the chi-square test.

Results The event-based injury incidence rate was 25.37 per 100 students per month (95% CI: 22.04–29.06). A majority (31.8%) of the injury events occurred during a sports event. Some contributory factors identified were overexertion (32.2%), starvation (19.7%), and lack of maintenance of the premises (15.4%). Common injury types were abrasions (33.5%) and lacerations (14.7%). Lower extremities (50.7%) were affected most. The majority of injuries (94.7%) fell to AIS 1, whilst 5.3% fell to AIS 2. Being a male (χ2=22.6, p<0.001), a member of ≥1 school sports teams, (χ2=11.6, p=0.001), and involvement in a physical fight during the last 30 days (χ2=5.7, p=0.01) were some of the risk factors for sustaining an injury. Only 42.3% had received first aid at school.

Conclusions & Learning Outcomes Event-based school injury incidence is very high in the study area. Recommendations can be made to adopt safety measures during sports, proper maintenance of the school premises and improvement of first aid facilities.