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1301.0 - Year Book Australia, 2006  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 20/01/2006   
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CHILDREN'S INJURIES

Children are much less likely to have long-term health conditions than adults, and infant and child death rates are generally declining and are at their lowest in a century. In 2003, 20% of the Australian population was aged 0-14 years (around four million children), while child deaths accounted for 1.3% of all deaths registered in that year. High rates of preventable injuries among children relative to other age groups are of concern to health professionals, the community and governments.

INJURY DEATHS

Most child deaths are of infants aged less than one year (68% of deaths of 0-14 year olds in 2003), and are related to perinatal and congenital factors. However, once the infancy period has passed, injury deaths (e.g. from transport accidents, drownings or assaults) emerge as the leading cause of death for children. Over the five-year period 1999-2003, 41% of all deaths of children aged 1-14 years were injury deaths (1,260 children) (graph 9.31). By comparison, injuries caused around 6% of deaths of people aged 15 years and over. The next most common cause of death of children aged 1-14 years - malignant neoplasms, or cancer - caused less than half the number of child deaths over the same period (537 children).

Graph 9.31: LEADING CAUSES OF DEATH FOR CHILDREN(a)(b)


Boys are more likely than girls to experience and die as a result of an injury. While half of all children are boys, nearly two-thirds of injury deaths for this age group between 1999 and 2003 were boys (62%). This difference between girls and boys in relation to injury and deaths exists regardless of the child's age, and across all OECD countries (UN 2001).


TRANSPORT ACCIDENTS

When infant deaths are included, there were 1,473 child injury deaths between 1999 and 2003 (table 9.32). Children who had died from injuries were more likely to have died in transport accidents, than in any other way - 587 children aged 0-14 years (40%) died this way between 1999 and 2003.

In most deaths that were the result of a transport accident, the child was either the occupant of a motor vehicle (44% of deaths) or a pedestrian (35%). The remaining deaths were in accidents where the child was a pedal cyclist (5%) or motorcycle rider (4%), or were other transport accidents (12%). Children were much more likely than adults to have been a pedestrian in the accident (16% of people aged over 15 years).

The overall decline in injury deaths between 1983 and 2003 was partly due to a decline in transport accident deaths. Many factors can contribute to such a decline, including accident prevention strategies (e.g. speed limit initiatives), improved car safety, improved emergency and medical response, or fewer children travelling on foot (UN 2001).

ACCIDENTAL DROWNING

Accidental drowning accounted for 19% of all child injury deaths between 1999 and 2003 (286 children). Other accidental threats to breathing, such as suffocation or choking, accounted for 11% (163 children). More than twice as many boys as girls drowned over the period (193 boys, 93 girls).

Children aged less than 5 years are most vulnerable to drowning - 80% of child drowning deaths were of children aged under 5 years (229 children). Most of these were 1-4 year olds, who are more mobile than infants but are still developing motor skills and not of an age to judge hazards. The death rate from accidental drowning for 1-4 year olds (3.9 per 100,000) was higher than for all age groupings for both children and adults.

The events leading to drowning were also different for young children - who tended to drown following a fall into water, while older children were more likely to have drowned once already in water. For example, most children aged less than 5 years who drowned in a swimming pool fell into the pool (78%).

The most common location of infant drowning was in the bath (62% of children aged less than 1 year). Drowning deaths of older children (aged 1-14 years) most commonly occurred in a swimming pool (42%) or a body of natural water such as a lake, river, stream or the open sea (24%).

OTHER TYPES OF INJURY DEATH

Assault accounted for 9% of child deaths (128 children) between 1999 and 2003. Young children were more likely to have died from assault than older children. Two thirds (65%) of child deaths from assault were of children aged less than 5 years (83 children). More boys than girls died from assault between 1999 and 2003 (70 compared with 58).

Other types of injury death each individually accounted for less than 5% of child deaths over the five year period. This included 64 children who died in accidents resulting from exposure to mechanical forces, and 50 who died in fires. A further 4% of children who died from injuries, died through intentional self-harm (56 children), most of whom were aged 13 or 14 years.

9.32 TOTAL CHILDREN INJURY DEATHS IN THE FIVE YEARS 1999 TO 2003(a)

Age (years)

Total deaths 0-14 years
under 1
1-4
5-9
10-14

no.
no.
no.
no.
no.
%

Transport accidents
17
182
161
227
587
39.9
Accidental drowning
29
200
35
22
286
19.4
Other accidental threats to breathing(b)
88
45
12
18
163
11.1
Assault
39
44
30
15
128
8.7
Exposure to mechanical forces(c)
10
25
13
16
64
4.3
Intentional self-harm
. .
. .
n.p.
n.p.
56
3.8
Smoke, fire, flames
7
21
14
8
50
3.4
Falls
3
12
11
7
33
2.2
Accidental poisoning
3
10
n.p.
n.p.
25
1.7
Other injury deaths
17
22
19
23
81
5.5
All injury deaths
213
561
299
400
1,473
100.0

(a) Persons aged 0–14 years.
(b) Includes accidental suffocation, strangulation, and hanging as well as selected other separate causes.
(c) Includes animate mechanical forces and inanimate mechanical forces.

Source: ABS data available on request, Causes of Death Collection.


RECENT INJURIES

While fatal outcomes are rare, the ABS 2001 NHS found that many more Australian children than adults had recently been injured. In 2001, 18% of children aged 0-14 years had received an injury in the previous four weeks for which some action had been taken. This proportion declined with age (ranging from 17% of 15-24 year olds to 6% of people aged 65 years and over).

While this included injuries needing minor first aid (e.g. applying a bandage), it extended to more serious events that required medical advice or hospitalisation. Injuries are the main reason children are hospitalised. In 2002-03 there were 68,000 hospitalisations of children aged 0-14 years for injury (graph 9.33).

Consistent with mortality patterns, boys are more likely to be injured than girls - in 2001, 19% of boys had recently been injured compared with 16% of girls. Boys were also hospitalised for injury more often than girls. In 2002-03, there were 42,600 hospitalisations for injuries to boys, and 25,400 to girls. Boys aged 10-14 years had the highest rate of hospitalisation among all boys. In contrast, hospitalisation for injury to girls peaked among girls aged 1-4 years. Thus, the difference between boys and girls was most marked among 10-14 year olds - boys this age had more than twice as many hospitalisations for injury as girls in 2002-03 (16,600 and 7,300 respectively).

Graph 9.33: HOSPITAL SEPARATIONS FOR INJURY(a) - 2002-03


ACTIVITY AND LOCATION WHEN INJURED

Australian children are generally physically active. Among 498,000 children aged 5-14 years who reported being injured recently, the most common activities these children had been undertaking at the time of injury were leisure activities (e.g. playing non-organised sport or games), and organised sports. In 2001, half of all recent injuries for children this age (51%) occurred during leisure activities, and around a third (27%) while children were playing sports. A further 17% occurred while attending school (Clapperton A. et al 2003).

The most common locations at which 5-14 year olds received injuries were outside their own or someone else's home (32%), at school (30%), at a sports facility (20%), or inside their own or someone else's home (16%).

EVENTS LEADING TO INJURY

In 2001, 11% of all children aged 0-14 years were injured in a fall, 3% in a collision (hitting something or being hit by something), 2% by a bite or sting, and 0.6% in an attack by another person.

Falls caused the greatest proportion of recent injuries for children (61%). Of children injured in falls, most were injured in a low fall of one metre or less (93%), rather than a high fall from more than one metre (7%), and most were engaged in sporting or leisure activities at the time (75%).

Collisions were the next most common cause of recent injury for children (17%). Boys were more likely to be injured this way than girls (20% of recently injured boys, and 13% of girls in 2001). As with falls, sports and leisure activities were the most common activities being undertaken at the time of the collision. Of children injured in collisions, 41% were participating in leisure activities (38% of boys and 46% of girls), and 34% were involved in sports (37% of boys and 29% of girls).

Of children recently injured, 12% were injured by a bite or sting (including bites from animals such as dogs and snakes, and some insects and spider bites). Children were more likely than any other age group to have been injured this way. Half (51%) of children who were bitten or stung were outside their own or someone else's home at the time.

In 2001, around 25,000 children had been injured in an attack by another person in the four weeks prior to interview - accounting for 4% of recent child injuries. Children were more likely than adults to have experienced injury from attack in the previous four weeks (0.8% of children aged 5-14 years compared with 0.2% of people aged 15 years and over). Most 5-14 year olds recently injured in an attack, had been at school at the time (72%) (AIHW 2003). Boys in this age group had been injured in an attack by another person at three times the rate of girls (1.2% and 0.4% respectively).

Graph 9.34: EVENTS LEADING TO RECENT INJURY(a) - 2001


References

UN (United Nations) 2001, Children's Fund, A League Table of Child Deaths by Injury in Rich Nations, Innocenti Report Card, Issue no.2, UNICEF Innocenti Research Centre, Florence.

Clapperton, A, Cassell, E & Wallace, A 2003, 'Injury to children aged 5-15 years at school', Hazard, edition no. 53, pp.1-16.

Australian Institute of Health and Welfare 2003, Rural, Regional and Remote Health: A study on mortality, Rural Health Series No.2, AIHW, Canberra.

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