The epidemiology of injuries in 4 child care centers

Objectives: (1) To describe the pattern of injury in preschool-aged childre n in 4 child care centers as compared with the results of other studies; (2 ) to compare injury rates by sex, age, and child care center; and (3) to ex amine environmental and child factors contributing to injury severity. Design: A 2-year cohort study of 362 preschool-aged children attending 4 ur ban child care centers. Teachers completed standardized injury forms on the type of injury, body location, site of injury, and contributing factors. Results: During the 2 years of the study, 1886 injuries were reported. The mean and median child injury rate was 6 and 4 injuries per 2000 exposure ho urs (equivalent to 1 full-time child care year), respectively. The majority of injuries (87%) were minor, occurred during free play (81%) and on the p layground (74%), and were precipitated by child-related factors (59%), such as being pushed. Boys had significantly higher median injury rates than gi rls. Age-adjusted injury rates for each child care center were significantl y different by center (F-3 = 61, P<.001). While moderate to severe injuries were more often precipitated by combinations of child and environmental fa ctors (chi(4)(2) = 20, P<.001), minor injuries were usually precipitated by child-related factors. Conclusions: Injury data from child cart centers are important for identify ing common risk factors for frequent or severe injury events and for design ing injury prevention programs. More research is needed to identify factors contributing to injuries, such as children's behavior and the child care c enters' physical and socioemotional environments.