 |
 |
 |
 |
||
 |
||
| Home | Command Papers | House Papers | Departmental Papers | Search | Site Map | Contact Us | Links | ||
 |
|
|
|
The
Health of Children and Young People
 6 Non-fatal accidents
6.1 Introduction 6.1.1 Coverage and purpose This chapter presents combined data about accidents from the 2001 and 2002 surveys of the Health Survey for England (HSE 2001 and HSE 2002). It concentrates on children (aged 0-15), including for the first time those under 2 years of age, and young adults (aged 16-24). Comparisons are made with HSE 1995-1997,1 allowing trends over time to be identified. Since it is a survey of people living in private households the Health Survey does not cover fatal accidents (these are covered in other statistics)2 and accidents which lead to long-term hospitalisation will inevitably be under-represented. However, it provides useful information on how and in what circumstances accidents occur, on types of accidents and injuries caused, and on the effect of the accident on everyday activities. In addition, a great deal of other information about the victim is available which allows associations between accidents and personal characteristics, for example physical activity levels, to be investigated. The chapter is divided into a number of sections. Sections 6.3 to 6.10 examine accidents, separately for sex and age groups, by type of accident, location of accident, injuries incurred, sources of help and advice, disruption to daily activities, and seasonal and regional variation. Section 6.11 looks at the relationship between accidents and socio-economic indicators, in particular NS-SEC of the household reference person, equivalised household income, area deprivation (IMD) and household composition. Sections 6.12, 6.13 and 6.14 focus specifically on children aged 0-15, relating accidents to the composition of the household in which the child lives, to their physical activity levels and to their psycho-social health. Section 6.15 examines potential risk factors for accidents, while Section 6.16 looks at trends over time, comparing 2001-2002 with 1995-1997. 6.1.2 Background Accidental injury is the most common cause of death among children and young people in Europe and America and puts more children in hospital than any other cause.3 The Government White Paper 'Saving lives: Our Healthier Nation', published in 1999,3 used mortality statistics and data on hospital inpatients from the Hospital Episode Statistics database (HES) to produce targets for reducing accidents. The targets set were to reduce the death rates from accidents by at least 20% and to reduce the rate of serious injury from accidents by at least 10% by 2010, from a baseline of 1995-1997 for mortality statistics and 1995-1996 for serious injuries from accidents (injuries leading to a hospital stay exceeding three days) as measured using HES data. The trend data reported here complement the data used to monitor Our Healthier Nation targets, as the focus is on accidents which do not result in death or long term hospitalisation. The reduction of injuries among children aged 0-4 is one of the objectives of 'Sure Start',4 the overall aim of which is to provide the best possible start in life for all children by bringing together early education, childcare and health and family support. One specific objective is a 10% reduction in the number of children aged 0-4 living in Sure Start local programmes and Children Centre areas admitted to hospital as an emergency with gastro-enteritis, lower respiratory infections or a severe injury. Some of the tables in this chapter show data for those aged 0-4 as a group, to allow them to be looked at separately.
6.2 Methodology 6.2.1 The questions asked The questions asked about accidents comprise a module of the HSE 2001-2002 questionnaire, included in Volume III, Appendix A. Questions on both major and minor accidents were the same as in HSE 1995-1997, except that in 1997 the questions were asked only of children, not of young adults. In the survey, accidents were defined as 'accidental events which resulted in injury or physical harm to you personally'. 'Accidental event' was not defined, but was left to the informant to interpret. In most cases, it would be clear what events should be included or excluded, but there may be a minority that might or might not be counted as accidents, depending on the informant's perception of the circumstances. In practice there is no means of checking whether or not the questions have been interpreted consistently by different informants or groups of informants, and it is assumed that the accidents recalled by different informants during the survey are comparable. 6.2.2 Accident classification and time periods Two types of accident are distinguished in the survey: 'major accidents' include all those about which a doctor was consulted or a hospital was visited, and 'minor accidents' include all other accidents that caused pain or discomfort for over 24 hours. For major accidents informants were asked to recall how many such accidents they had had in the six months prior to interview, and to state in which months these accidents occurred. For the most recent accident only, they were asked to give details about how and where the accident occurred and the disruption it caused in work/school (where applicable) and to normal daily activities. The recall period for minor accidents was four weeks prior to interview. Informants were asked to recall the total number of minor accidents occurring over the four weeks and to specify the number of accidents per week. This allowed accident rates for alternative recall periods to be calculated (see below). Details were requested about the two most recent accidents. The choice of reference periods for major and minor accidents is intended to define periods sufficiently long to generate details of enough accidents for analysis purposes, yet short enough for informants to remember all, or at any rate a high proportion of, their accidents, with accurate supporting detail. The shorter recall period for minor accidents reflects an assumption that they will be remembered less readily.5 Two main types of recall bias can be anticipated in responses to past accidents. First, memory decays over time, and accidents occurring more recently are easier to remember than more distant events. Second, there is a phenomenon often referred to as 'telescoping', which is a general tendency to report events as happening more recently than they in fact did occur. The possibility of bias in the recall was discussed in the 1995 HSE report.6 In brief there was some evidence of a small recall bias in the data on major accidents. The main problem seemed to be that informants forget accidents occurring in the earlier part of the six-month period. There was some evidence of an offsetting tendency for some accidents occurring outside the six-month period to be included in the earliest month of the period. There was little difference in these biases between adults and children or between males and females. With regard to minor accidents the recall bias was more serious, being greater for children than adults, and greater for boys than girls. The bias seems to be due to informants having considerable difficulty in remembering all minor accidents occurring in the last four weeks. It was found in 1995 that if the recall period was reduced from four weeks to two weeks the bias was considerably reduced. Therefore subsequent HSE reports calculated minor accident rates, and accident rates for different types of accident, based on a two week recall period rather than the full four weeks, and this report has followed suit. However, analysis of the characteristics of accidents, such as where they occurred or whatinjuries they caused, have included all minor accidents about which data was collected even if they were outside the two week recall period. It should be noted that although this increases sample sizes for analysis of accident characteristics it does so at the expense of introducing some bias into the estimates, because minor accidents recalled from the period three to four weeks before the interview are likely to be somewhat more serious than more recent minor accidents. 6.2.3 Derivation of accident rates and weighting to compensate for selection bias Because any one informant may have had more than one major accident during the six-month reference period, comparisons between sub-groups are based upon the mean number of reported accidents over the reference period. Such an approach tends to give very low figures (typically around 0.1) so, to aid comparisons, the means for major accidents have been multiplied by a factor of 200 (two six-month periods x 100 persons) to give an annual accident rate per 100 persons. The multiplier used for minor accidents was 2600 (26 two-week periods x 100 persons), again giving an annual accident rate per 100 persons. Although information was collected about the total number of major accidents over the relevant reference period, detailed information was collected on only the most recent major accident. Using the raw data to derive estimates about the kinds of accidents people have would lead to biases, since this selection process leads to the over-representation of the accidents of people for whom accidents are relatively uncommon events. To avoid this bias, the data have been weighted when analysing the detailed data on individual accidents. In the case of major accidents the weight per informant is the total number of accidents experienced in the reference period. In the case of minor accidents the weight per informant is calculated as the total number of minor accidents in the full four-week reference period divided by the number of accidents about which details were collected. 6.3 Accident rates by age and sex 6.3.1 Major accidents Table 6.1 shows the proportion of children and young adults reporting a major accident in the six months prior to interview, and also shows the estimated annual accident rate per 100 persons calculated as described above (Section 6.2.3). 11% of boys and 8% of girls aged 0-15 reported having at least one major accident in the six months prior to interview. The proportion reporting more than one major accident was 1% of both boys and girls. 16% of young men and 8% of young
women reported having at least one major accident in the six months prior
to interview. The proportion reporting more than one major accident was
1% of both men and women. Table 6.1
Annual accident rates per 100 persons were 24 in boys aged 0-15, 19 in
girls 0-15, 36 in young men and 18 in young women. The following table
brings these figures together.
Major accident rates were higher for males than females. Among males, rates were significantly higher among young men than among boys, but this age difference was not seen among females. Figure 6A shows trends by age calculated using moving averages of three consecutive age years, to reduce any tendency for the general trend to be obscured by erratic differences between individual age years, due to sampling error. It should be noted that the moving average process creates slight apparent discrepancies between the diagrams and the tables, for example, in the exact location of peaks in the distribution. Diagrams should be taken as showing the broad pattern, with detail being better seen in the tables. Major accident rates among those under one year of age were much lower than at any other age. There was then an increase over the first few years, rates then falling again to a lower level at around ages 5-8 before subsequently increasing. Up to about age 10, differences in major accident rates between boys and girls were not very large (though rates for boys were higher, except among very young children). From age 10, the gap widened, the upward trend ceasing among females but continuing among males. In both sexes, there was a temporary fall in major accident rates in the late teens. Rates were much higher among young men than young women, the gap tending to widen with age. Table 6.1, Figure 6A 6.3.2 Minor accidents 6% of boys, 5% of girls, 11% of young men and 6% of young women reported having at least one minor accident in the two weeks prior to interview. The percentage reporting more than one accident was 1% of boys and girls, 2% of young men and 1% of young women. Minor accident rates among those aged 0-15 were significantly higher among boys (210 per 100 persons) than among girls (159 per 100 persons), and among young men (357 per 100 persons) than among young women (177 per 100 persons). Minor accident rates were significantly higher among young men (357 per 100 persons) than among boys aged 0-15 (210 per 100 persons). The corresponding difference between young women and girls was not significant. Table 6.1
Figure 6B shows the estimated minor accident rate for all ages for both sexes, again using moving averages of three age years. The age pattern for minor accidents was different from that of major accidents. There was a steady increase in the minor accident rate for both sexes until the early teens, with broadly similar rates in both sexes up to that point: the increase continued for males but not for females, so that by the mid-teens, rates were much higher for males than females. This gap remained as rates in both sexes declined from the mid-teens into the twenties. Table 6.1, Figure 6B
6.4 Types of accident Annual accident rates for different types of accident are shown in Tables 6.2 (for children) and 6.3 (for young adults). Informants were asked whether the accident was due to a fall, occurred during sports/exercise (in those aged 2 and over), or play (in those aged 2-12), involved a moving motor vehicle, involved a bicycle or other moving non-motor vehicle, or was caused by a tool, implement or piece of electrical or mechanical equipment. In addition informants aged 16-24 were asked if the accident occurred at work. Types of accident are not mutually exclusive and any one accident may contribute to the accident rate of more than one accident type. A common example was a fall that occurred during sports or exercise. In analyses of young adults, the accident rate for falls is presented in two different ways: all falls, and falls other than those occurring during sports or exercise. Some accidents did not belong in any of the specified categories, and are not included in the tables showing accident types. The two most common types of major accident were falls, and accidents
during sport/exercise or play. It is reported that in England about 800,000
people are injured while playing sport, 215,000 of them children.3
The sports/exercise major accident rate was 13 per 100 young men and 3
per 100 young women. The rate for major falls, excluding sports/exercise,
was 8 for young men and 6 for young women. Rates for major accidents involving
moving motor vehicles were 5 for young men and 3 for young women, and
1 and 0 respectively for major accidents involving bicycles. Rates for major accidents involving the use of tools or other implements were 5 for young men and 1 for young women. The table below summarises these figures, and compares them with minor accident rates in the same categories. Of particular note is the high minor accident rate seen for tools or other implements, particularly among young men where the rate was 86 per 100 persons. These figures present a pattern broadly similar to that shown in HSE 1997. For both major and minor accidents, rates were generally higher for males than females. The major exception was falls other than those during sport/exercise.
The following table gives annual rates per 100 for different
accident types among children.
* Those aged 0 and 1 were not asked if their accident had
occurred during
Rates for major accidents involving moving motor vehicles were 1 for both boys and girls, while rates for accidents involving a bicycle were 2 for boys and 1 for girls. These figures are slightly lower than expected,3 but is important to remember that accidents resulting in a fatality or long-term hospitalisation are not included here. Accident rates were higher for boys than girls in a number of categories, particularly sports/exercise/play. As would be expected, rates for accidents involving tools were considerably higher for young adults than for children. Rates among young adults were also higher for accidents involving a moving motor vehicle. It must be remembered that the figures for children are the average of ages 0-15, and that in some parts of the age range rates are considerably higher than the average. Figure 6C (again with moving averages of three age years) shows the variation in sports/exercise/play major accident rates by age, separately for males and females. Major sports/exercise/play accidents peaked at around age 10-11, and then decreased until levelling off from about 18. Throughout the age range from about age 3, male rates were considerably higher than female rates, the gap widening from about age 10. Figure 6C Rates of minor accidents involving moving non-motor vehicles
(primarily bicycles) showed a sharp peak among boys in their mid teens,
but not among girls. Tables 6.2, 6.3
6.5 Location of accidents 6.5.1 Location of major accidents The bases for Tables 6.1-6.3, discussed above, comprised the children and young adults interviewed. The bases in the tables discussed in Sections 6.5 to 6.11 comprise the accidents themselves, the objective being to examine their characteristics: location of accident (6.5), the type of injury caused and the part of the body injured (6.6), where help or advice was obtained for each accident (6.7), whether activities were disrupted and time taken off work (6.8), the season in which (major) accidents occurred (6.9), and finally accident rates by region (6.10). In very young children (aged 0-4), by far the most common place for a major accident to occur was a home or garden (73% of accidents to boys and 77% of accidents to girls). This was also the most common location among girls aged 0-15 (44%), while among boys similar percentages reported that the accident had occurred in a home or garden (35%) and in a place used for sport or recreation (32%). 13% of both boys and girls aged 0-15 reported that the accident had occurred in a school or other public building. Among young men aged 16-24 the most common place for a major accident to occur was a place used for sport or recreation (34%) while in young women similar percentages were seen for a home or garden (32%) and 'other outdoors' (29%). Table 6.4 6.5.2 Location of minor accidents Most minor accidents among those aged 0-4 were also reported to have occurred in a home or garden. (60% boys and 58% girls). In boys aged 0-15 the most common location was reported to be a place used for sport or recreation (41%) while in girls it was in a home or garden (37%). In young men the majority of minor accidents were reported to have occurred in a place used for sport or recreation (38%) while in young women a similar percentage was reported to have occurred in a home or garden (35%) and workplace, school or public building (32%). Table 6.4
6.6 Types of injury and part of the body sustaining the injury 6.6.1 Types of injury in major accidents Informants were asked to describe the injuries they incurred in the most recent accident and the part of the body that was injured. The most common injuries among children of all ages from major accidents were 'cutting, piercing or grazing part of the body', 'swelling or tenderness in some part of the body' and 'bruising, pinching or crushing'. In young men aged 16-24 the most common injury was 'swelling or tenderness in some part of the body' (43%) while in young women it was 'straining or twisting part of body' or 'swelling or tenderness in some part of the body' (41% for each). The proportion of major accidents resulting in a broken bone was 7% for boys aged 0-4, 5% for girls aged 0-4, 16% for boys aged 0-15 and 13% for girls aged 0-15. Corresponding figures in young adults aged 16-24 were 15% in men and 11% in young women. In major accidents to children aged 0-4 the most common part of the body affected by the accident was head, neck or face (55% of boys and 58% of girls), while for children aged 0-15 and in young adults it was arm, leg or shoulder (57% of boys, 64% of girls, 70% of young men and 67% of young women). Tables 6.5, 6.6 6.6.2 Types of injury in minor accidents In children aged 0-4 the most common injuries as a result of minor accidents were also 'cutting, piercing or grazing part of the body', 'swelling or tenderness in some part of the body' and 'bruising, pinching or crushing'. Among those aged 0-15 the most common injury was 'bruising, pinching or crushing'. This was true for both boys (46%) and girls (44%). In boys aged 0-4 the most common part of the body to be injured was head, neck or face (37%), while in girls similar percentages reported injuring head, neck or face (33%) and arm, leg or shoulder (32%). In children aged 0-15 and in young adults the most common part of the body to be injured was arm, leg or shoulder (47% of boys, 46% of girls, 53% of young men and 46% of young women).Tables 6.5, 6.6 6.7 Source of help or advice 6.7.1 Help and advice for major accidents Answer categories shown in Table 6.7 were hospital only, GP surgery only, both hospital and GP surgery, and 'other'. The overall proportion of accidents involving help and advice from a hospital is the total of the first and third categories, and getting help and advice from a GP surgery is the total of the second and third. Not surprisingly given the definition of major accidents, the great majority of major accidents to children aged 0-15 (82% of accidents to boys and 79% of accidents to girls) involved getting help or advice from a hospital (70% and 64% respectively from a hospital only, 12% and 15% respectively from both a hospital and a GP surgery). The overall proportion of major accidents involving getting help and advice from a GP surgery, including accidents where help was also sought from a hospital, was 25% for boys, 32% for girls. Overall, 72% of major accidents to young men and 67% of accidents to young women involved getting help and advice from a hospital. Corresponding figures for GP surgery were 37% and 45%. Young adults were thus relatively less likely than children to get help from a hospital and more likely to get it from a GP surgery. Table 6.7 6.7.2 Help and advice for minor accidents A very different picture was seen with regard to minor accidents, of which very few involved either a hospital or a GP surgery. Table 6.7
6.8 Disruption to normal daily activities and time taken off school, college or work as a result of an accident Informants were asked whether they had to give up or change any of their normal activities as a result of the accident. Table 6.8 gives the estimated duration of disruption to normal daily activities for major and minor accidents. As would be expected the length of time normal daily activities were disrupted was considerably longer for major accidents than for minor ones, for both children (0-15) and young adults (16-24). Among adults, about one in ten major accidents affected their victims' activities for a month or more (11% young men, 10% young women). Corresponding figures for children were lower (7% boys, 8% girls). Around half of major accidents affected the victim's activities for less than a day, or not at all (boys 53%, girls 49%, young men 51%, young women 40%). The proportion of minor accidents affecting their victims' activities for a day or more was 17% boys, 15% girls, 14% young men, 17% young women. Table 6.8 The length of time taken off work, school or college as a result of a major accident was similar for both sexes, but greater in young men and women than in children. The proportion of major accidents that involved their victims taking a week or more off work or school was 6% boys, 9% girls, 16% young men, 17% women. Table 6.9 The length of time taken off school, college or work as a result of a minor accident was not asked. 6.9 Seasonal variations in major accident rates Table 6.10 shows the seasonal distribution of major accidents for children and young adults. Patterns of seasonal variation were not strongly marked. The season with the largest proportion of major accidents to children aged 0-15 was the summer (30% of accidents to boys and 29% of accidents to girls). Children's major accidents were least likely to occur in winter (18% of accidents to boys and 20% of accidents to girls), perhaps reflecting lower physical activity levels in winter, as shown in the physical activity chapter of this report (Chapter 4, Section 4.2.5). Accidents to young men were also most likely to occur in summer (28%) while for young women most major accidents occurred in spring or winter (27% in each case). Table 6.10 6.10 Accident rates by region There were no significant differences in major or minor accident rates between different regions in either children or young adults. Table 6.11
6.11 Accident rates by socio-economic indicators 6.11.1 Major accidents Accident rates were analysed by three socio-economic indicators: NS-SEC, equivalised household income and area deprivation (Index of Multiple Deprivation IMD). NS-SEC is a classification of social position that was introduced in the 2001 census. It has similarities to Registrar General's Social Class. Informants are assigned to an NS-SEC category based on the current or former occupation of the household reference person. Equivalised household income is a measure of household income that takes account of the number of persons in the household. IMD combines, at electoral ward level, a number of indicators that cover a range of domains (income, employment, health deprivation and disability, education skills and training, housing and geographical access to services) into a single deprivation score for each area. NS-SEC Boys whose household reference person (HRP) was in a managerial and professional occupation or was a small employer or own account worker had significantly lower major accident rates (22 and 21 per 100 persons respectively) than those whose HRP was in a semi routine or routine occupation (28 per 100 persons). Girls whose HRP was in a managerial or professional occupation or was a small employer or own account worker had significantly lower major accident rates than those in other NS-SEC groups. Among young adults (16-24) there was no association between major accident rates and NS-SEC. Table 6.12 Equivalised household income quintile Boys in households in the lowest two income quintiles had significantly higher major accident rates than those in the three highest income quintiles. Girls whose household income was in the lowest three income quintiles had significantly higher major accident rates than those in the highest quintile. Among young adults (16-24) there was no association between household income and major accident rates. Table 6.13, Figure 6D Area deprivation index (IMD) Among boys and young adults, there was no significant association between major accident rates and the degree of area deprivation. Among girls, the lowest major accident rates were seen in the least deprived quintile (15 per 100 persons), and rose successively with increasing degree of deprivation to 21 per 100 persons in the most deprived IMD quintile.Table 6.14, Figure 6E 6.11.2 Minor accidents NS-SEC There was no significant association, for any of the groups, between minor accident rates and the occupation of the HRP. Table 6.12 Equivalised household income There was no clear pattern of association between equivalised household income quintile and minor accident rates. Table 6.13 Area deprivation index (IMD) The level of area deprivation had little association with minor accident rates in either children or young adults. Table 6.14 6.12 Accident rates and household composition 6.12.1 Major accidents This and the following sections (6.13 and 6.14) deal solely with children, and examine the associations of major and minor accident rates with household composition, with physical activity levels and with children's psycho-social health. Tables 6.15, 6.16 and 6.17 examine associations between accident rates and the household composition of the child to whom the accident occurred, that is, the number of adults in household, the number of children living in the household and the child's position relative to other children living in the household. Number of adults in household Major accident rates were associated with the number of adults living in the household, rates being significantly higher in households with only one adult than in those with two or more adults. This finding is in agreement with Fleming and Charlton,8 who also reported that accident rates were highest amongst households with only one adult. Table 6.15 Number of children in household The number of children in the household had no clear relationship with major accident rates, for either boys or girls. Table 6.16 Position of child in household There was no clear association between major accident rates and the position of the child in the household relative to other children (only child, eldest child, middle child, youngest child). This was true for both boys and girls. Table 6.17 6.12.2 Minor accidents Number of adults in household Boys in households with one adult also tended to be more likely to have a minor accident than those with two or more adults, but this difference was not significant. Among girls there was little difference in accident rates between households with one adult and those with two adults. Minor accident rates were lower in households with three or more adults, but this difference was not significant. Table 6.15 Number of children in household The number of children in the household showed no clear relationship with minor accident rates in either boys or girls. Table 6.16 Position of child in household Overall, the middle or youngest child had lower minor accident rates than those who were the eldest or only child. This was true for both boys and girls. Table 6.17 6.13 Children's accident rates by physical activity levels 6.13.1 Major accidents Table 6.18 shows accident rates by the amount of physical activity undertaken per day by the child to whom the accident occurred. Major accident rates were significantly higher in boys (0-15) who spent one hour or more each day participating in physical activity than in boys who spent less than an hour (29 per 100 boys compared with 20 per 100 boys). There was no significant difference in major accident rates between girls (0-15) who spent one hour or more participating in physical activity and those who did not. Table 6.18 6.13.2 Minor accidents In both boys and girls aged 0-15, minor accident rates were higher in those who participated in physical activity for one hour or more per day than in those who spent less than one hour. Table 6.18 6.14 Children's accident rates by SDQ Total Deviance score 6.14.1 Major accidents Table 6.19 looks at accident rates by a score computed from the Strengths and Difficulties Questionnaire (SDQ). The SDQ is designed to detect behavioural, emotional or relationship difficulties in children aged 4-15, and is discussed more fully in Health Status (Chapter 7 of this report). Questions were administered to parents in self-completion format, to complete in respect of each child aged 4-15. The questionnaire consists of 25 questions, with five questions in each of the following scales (or domains): hyperactivity, emotional symptoms, conduct problems, peer problems and pro social behaviour. The addition of the scores of the first four scales yields a Total Deviance Score, with a maximum score of 40. A score of 17 or more is considered high. This section looks at accident rates in relation to the Total Deviance Score only. Among boys aged 4-15, those with the highest scores for total deviance also had the highest major accident rates, while among girls aged 4-15, those with the lowest Total Deviance scores had the lowest major accident rates. Table 6.19 6.14.2 Minor accidents There was little association between Total Deviance Score and minor accident rates among boys aged 4-15. Among females aged 4-15, higher minor accident rates were associated with high scores for total deviance. Table 6.19 6.15 Factors predictive of major and minor accidents Multiple logistic regression was carried out to identify risk factors for accidents. Logistic regression is used to model the probability p of the occurrence of a binary or dichotomous outcome based on values of a set of predictor variables. Logistic regression coefficients can be used to estimate odds ratios for each of the independent variables in the model. As the simultaneous effects of the independent variables are analysed, the contribution of each variable depends on the other variables in the model. The variables included in the analysis were age, NS-SEC of household reference person (HRP), number of children in the household, equivalised household income, number of adults in the household, area deprivation (IMD), Government Office Region, physical activity and SDQ Total Deviance Score. Forward stepwise procedures were used and only the variables that were found to be significant in one or more of the models are presented in Tables 6.20 and 6.21. Age The odds of having a major accident increased with age in boys. In girls, there was also some tendency for the odds to increase with age, but this did not reach overall significance (although the odds for those aged 10-12 were significantly higher than for those aged 4-6). The odds of having a minor accident increased with age in both males and females. NS-SEC The reference category was taken as those whose HRP was in a managerial or professional occupation. Relative to this group, boys whose HRP was in a semi-routine or routine occupation had significantly less chance of having a minor accident (odds 0.52), as did boys whose HRP was in a lower supervisory or technical occupation (odds 0.64). For minor accidents to girls, or major accidents to either sex, there was no clear relationship to NS-SEC. Physical activity The odds of having a major accident were higher among boys who did one hour or more of physical activity (odds 1.33) a day than among those who did less than one hour.The odds of having a minor accident were higher in both boys (odds 1.96) and girls (odds 1.37) who did one hour or more of physical activity per day than in those who did less than one hour. SDQ The reference category for boys and girls was those with a Total Deviance Score of less than 14. Boys with a Total Deviance Score in the range of 17 or more were more likely than the reference group to have a major accident (odds 1.62). Girls with a total deviance score of 17 or more were more likely to have a minor accident than the reference group (odds 1.81). Government Office Region Females living in the East Midlands were more likely to have a minor accident (odds 2.0) than the reference group, those living in London. Number of adults in the household Boys living in a household with three or more adults were less likely (odds 0.60) to have a major accident than boys living in a household with one adult. Girls living in a household with three or more adults were less likely to have either a major (odds 0.62) or minor (odds 0.49) accident than girls living in a household with one adult. Tables 6.20, 6.21 6.16 Accident rates: comparisons between 1995-1997 and 2001-2002 6.16.1 Major accidents In looking at trends, it should be noted that whereas child accident data was available for all three years 1995, 1996 and 1997, in the last of these no accident data were obtained from young adults. Comparisons in respect of this age group thus relate only to 1995 and 1996. It should also be noted that whereas the 2001 and 2002 surveys covered children of all ages, the earlier group of surveys did not cover those aged 0 or 1. Comparisons of child data are therefore confined to those aged 2-15. Table 6.22 shows annual accident rates for 1995-1997 and for 2001-2002 for males and females aged 2-24. Figures 6F and 6G show this data graphically, but smoothed using moving averages of three age years. Major accident rates among males were significantly lower in 2001-2002 than in 1995-1997. This was true for both boys aged 2-15, where rates decreased from 31 to 26 per 100 persons, and for young men aged 16-24, where rates decreased from 42 to 36 per 100 persons. Among females accident rates were also significantly reduced from 22 to 19 per 100 girls aged 2-15 and from 22 to 18 per 100 young women aged 16-24. Table 6.22 The following table summarises these figures.
The diagrams show the age patterns in more detail. Up until the early teens, major accident rates did not differ greatly between the two periods, but from then on they were lower in 2001-2002 before converging again in the early twenties. Figure 6F 6.16.2 Minor accidents Figures 6G shows the corresponding figures for minor accidents. The observed differences between the two periods in minor accident rates did not represent significant changes in any of the four groups, although that for girls approached significance. Table 6.23, Figures 6G
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
