Elsevier

Injury

Volume 37, Issue 5, May 2006, Pages 416-422
Injury

Childhood injuries from motor vehicle–pedestrian collisions in Wuhan, The People's Republic of China

https://doi.org/10.1016/j.injury.2005.12.002Get rights and content

Summary

Objectives

To examine motor vehicle–pedestrian collision injuries resulting in hospitalisation among children admitted into Wuhan Children's Hospital, The People's Republic of China.

Methods

From the 1993 to 2004 inpatient data of Wuhan Children's Hospital, we identified injury cases from motor vehicle traffic crashes among children aged 18 years or less using the discharge diagnosis defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). We examined characteristics of injuries from motor vehicle traffic crashes (ICD-9-CM = E810–E819) and then calculated the proportion of injuries from motor vehicle–pedestrian collisions (ICD-9-CM = E814) among all hospitalisations for childhood injuries (ICD-9-CM = 800–959). The trend of injuries from motor vehicle–pedestrian collisions from 1993 to 2004 was described.

Results

Of the 12,939 injuries resulting in hospitalisation among children admitted into Wuhan Children's Hospital during 1993–2004, a total of 528 injuries were caused by motor vehicle traffic crashes. The majority of the injured children in motor vehicle traffic crashes were males (59.3%). In comparison with other traffic injuries, a higher proportion of motor vehicle–pedestrian collisions occurred among children aged 12–15 years. Motor vehicle–pedestrian collision injuries resulted in significantly longer lengths of stay in the hospital than other motor vehicle traffic injuries (19.4 days versus 14.3 days, respectively; t-test = 2.59, p-value < 0.05). The percentage of motor vehicle–pedestrian collision injuries among all hospitalisations for childhood injuries increased significantly from 1.6% (95% confidence interval [CI] = 1.2–2.1) in 1993 to 3.1% (95% CI = 2.7–3.6) in 2004 (p < 0.05).

Conclusions

Hospitalisations for injuries from motor vehicle–pedestrian collisions at this large children's hospital increased significantly in the past decade. These data underscore the need for additional research and a major concerted effort to prevent motor vehicle–pedestrian collisions among children in China.

Introduction

Injuries are a leading cause of morbidity and mortality for children around the world.2, 12, 15, 21, 23, 24, 31, 35 Traditionally, infectious diseases predominated as the leading cause of mortality in developing nations. However, as economic and living conditions in some developing nations improved, the leading cause of death among children in these nations shifted to injuries.2, 12, 15, 21, 23, 24, 31, 33, 35 Although there have been substantial declines in injury death rates among children in developed nations,4, 11 possibly attributable to rigorous injury research and active injury prevention,7, 8, 9 the impact of injuries on children in developing countries has not been researched to the extent that the magnitude of the problem requires.1, 3, 6, 8, 9, 14, 16, 18, 35 Thus, research on childhood injuries in developing countries is rarely seen in the scientific literature.8, 9, 14, 35

China is one of the developing countries that have experienced rapid modernisation and urbanisation during the past decade. Along with rapid modernisation, the profile of major public health threats to children in China has shifted.13, 33, 34 Unintentional injuries are currently the leading cause of death among children in China, with more than 80,000 children dying from injuries each year.25 In addition, motor vehicle traffic crashes have become the second leading cause of both death and injury-related hospitalisations among children and young adults.13, 28

Researchers have tested the hypothesis that motor vehicle traffic crashes have increased in conjunction with the 266-fold increase between 1990 and 1999 in motor vehicle ownership in China.28, 29, 32 Official data from China report that in 1998, the number of road traffic crashes, traffic-related deaths, and injuries were 58.4, 91.6, and 43.2 times higher, respectively, than in 1951, and 3.2, 4.0, and 3.0 times higher, respectively, than in 1978.28, 29 In 1999, pedestrians accounted for 26% of all road users killed in road traffic crashes.24 As motor vehicle ownership increased dramatically and as traffic roads expanded to even small villages during the past decade, road traffic injuries have been recognised as an important public health problem in China.28, 29, 32 Yet, injuries from motor vehicle–pedestrian collisions among children in China have yet to be described in detail.7, 28, 29

This study examines patterns of childhood injuries from motor vehicle traffic crashes that resulted in hospitalisations from 1993 to 2004 in a large metropolitan children's hospital of southern China. Of special interest are the trends over time and characteristics of injuries from motor vehicle–pedestrian collisions. We hypothesise that the proportion of injuries from motor vehicle–pedestrian collisions among all hospitalisations for childhood injuries at this children's hospital increased significantly during the past decade.

Section snippets

Data source

Hospital discharge data from Wuhan Children's Hospital were used in this study. With a city population of approximately 4.5 million in 2001, Wuhan is the capital city of Hubei Province, The People's Republic of China. Wuhan Children's Hospital is the only comprehensive children's hospital in Hubei Province and it has been ranked as one of the best children's hospitals in China. Supported by approximately 700 medical staff and researchers, Wuhan Children's Hospital provides a full range of

Results

A total of 12,939 injury-related hospitalisations among children admitted to Wuhan Children's Hospital were identified and analysed for the study period. Injury-related hospitalisations accounted for approximately 4–5% of all hospitalisations each year among children aged 18 years or less. Fig. 1 illustrates the changes in hospital charges over time for all injuries and for motor vehicle traffic-related injuries. From 1993 to 2004, the total number of discharges for all injuries increased by

Discussion

The results of this study indicate that the proportion of injury-related hospitalisations from motor vehicle–pedestrian collisions among all injury-related hospitalisations at the Wuhan Children's Hospital doubled from 1993 to 2004, with children aged less than 6 years having the highest number of these injuries. Our findings support the hypothesis that injuries from motor vehicle–pedestrian collisions admitted into this large comprehensive children's hospital increased significantly during the

Human participant protection

De-identified data were prepared by the Wuhan Children's Hospital for analyses that were conducted by researchers at School of Public Health, Tongji Medical College, Wuhan, China. The research data contained no personal identifiers, and no human subjects were involved in the study. Thus, no institutional review board approval was required for this secondary data analysis study.

Acknowledgements

Data analysis and preparation of the manuscript was supported in part by a research grant from the Centres for Disease Control and Prevention, the U.S. Department of Health and Human Services to Dr. Xiang (Grant #: R49CE00241-01). The views expressed here are those of the authors and do not necessarily reflect the official views of the Centres for Disease Control and Prevention.

We thank Sara Sinclair at the Centre for Injury Research and Policy, Columbus Children's Research Institute for

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