• Written by Kate Hunter, Senior Research Fellow, George Institute for Global Health
imageKids play and explore. It's up to us to make sure they can do so safely.from

We all do our best to protect our kids from harm, but the adventures of childhood usually come with at least a few injuries. While no parent wants to wrap their kids in cotton wool, a new study has reported injury as the leading cause of death in children in Australia. About 100 Australian children die each year from injuries.

The authors looked at data from 2002-2012 where there were over 680,000 injury-related hospitalisations for kids (aged under 16) across Australia, caused mostly by falls and transport-related injuries.

The authors estimate treatment for these injuries costs A$212 million each year.

Given climbing trees and racing bikes is all part of childhood, can this figure be reduced?

Preventing injuries in kids

Even though injury prevention and control has been a national health priority area in Australia since 1996, we do not have a national plan for preventing injury.

A good example of how parents and policy need to work together to prevent injury in kids is motor vehicle crashes. Local and international studies have shown children sustain worse injuries in road crashes when they’re not in the right car seat for their age.

A child car seat either features a five-point harness which fits the smaller frame of a child, or raises the seat to better position the older child within the adult seat belt in “booster seats”. Both of these types of child car seats address the mismatch between a child’s smaller stature and the size of an adult car seat.

In 2009, the Australian national road rules were changed, specifying different child car seats by age up to seven years. Population based surveys found pre-school aged children were more than twice as likely to be in the right car seat for their age after this legislation was implemented.

Reductions in both fatal and non-fatal injuries have been projected and it’s estimated if we achieve 75% uptake in age-appropriate child car seats, ten out of 100 fatalities, and 26 out of 100 serious, injuries will be prevented.

We conducted a study in 2010 that found even more kids were in the right car seat when parents were educated about car seats. We did this by demonstrating and distributing restraints in pre-schools and daycare centres. This was particularly useful for non-English speakers who may have trouble accessing information in other ways.

What types of injuries?

The new study found transport injuries (which included injuries to pedal cyclists, motorcyclists and car passengers) were responsible for 13.7% of hospitalised injuries in children. Specific strategies are needed - including ensuring children ride bikes or scooters in safe areas away from road traffic, supervising riding, checking bikes and scooters and ensuring children have the right protective equipment. A bike helmet is essential and knee, elbow and wrist guards are important for other activities like skateboarding or rollerblading.

imageMost falls occur in the home and on playgrounds.from

Falls are an important part of childhood development as children learn to walk and begin to explore their environment, but they can also result in severe injuries. Falls were responsible for more than a third of hospitalised injuries in children in the study period.

The study also found the pattern of fall-related injuries varies according to age: children younger than five more frequently suffer a head injury (34%), older children who are able to protect their head by putting their arms out to stop a fall more likely had arm fractures.

Children under five mostly fall in the home, but older children fall in playgrounds. Though there are few studies in how to prevent childhood falls, some real-life policies have made a difference. Legislation requiring mandatory window guards can reduce falls from height by half, even in high density cities where it’s common for multiple families to live in one dwelling.

Product changes such as replacing baby walkers with stationary activity centres and redesign of baby walkers so they can’t fall down stairs has dramatically reduced baby-walker related injuries. Protective equipment, such as mouthguards for sporting activities can minimise harm and there is strong evidence bike helmets prevent head injuries.

Lessons for parents

Fortunately there are things parents can do to minimise children’s risk of injury while ensuring they stay active. In the home, for example, there is the child home safety checklist that includes things such as safe storage of medicines and poisonous substances.

When playing contact sport we can make sure our children have mouthguards. If riding a bike, we can make sure they use a bike helmet that meets the Australian standard and make sure it fits well. There are other resources to help parents keep their children safe, such as resources to help you choose the right child car seat.

Childhood is the best time to play and explore. It’s the responsibility of parents and governments to make sure kids can do this safely without injury.

Kate Hunter receives funding from or has worked on projects funded by: NHMRC, ARC, NSW Health, Transport for NSW and the Aboriginal Health and Medical Research Council of NSW. In addition, she is funded by a NSW Health Early Mid Career post doctoral fellowship. She is affiliated with the Australian Injury Prevention Network and is a sitting Council member for Kidsafe NSW.

Lisa Keay receives funding from NHMRC, ARC, NSW Government and the World Health Organisation. She is affiliated with the Australasian College of Road Safety and the Australian Injury Prevention Network.

Authors: Kate Hunter, Senior Research Fellow, George Institute for Global Health

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