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Background
Injury was the leading cause of death among children age one
to fourteen in Hong Kong. In particular, among all traumatic injuries,
unintentional injuries accounted for approximately 76% of the
total in 1996. Confronted with such injuries among children, the
Department of Health in Hong Kong summoned the following in its
Public Health Report No. 3. "Suitable studies should be conducted
to investigate specifically the incidence of childhood injuries,
circumstances and contributing factors, severity and long term
outcome, as well as economic costs." Meanwhile, innovations
in hospital-based injury studies around the world have been rapidly
evolving during the last two decades, and recently, the World
Health Organization (WHO) have proposed a new data standard to
describe external causes of injury. With the advent of a new external
cause coding system, as well as the experience accumulated from
major international surveillance studies, the present project
was positioned at an appropriate timing in terms of the development
of this field.
Objectives
Focusing on unintentional residential childhood injuries (URCI)
as:
- Provide an overall pattern of morbidity from childhood injuries
and their correlates such as socio-economic background, demographic
information, antecedent context and
- Facilitate injury prevention initiatives and prevention efforts.
Design
Case review of all trauma intakes
at three local hospitals: Prince of Wales Hospital, Pamela Youde
Nethersole Eastern Hospital, and United Christian Hospital, and
a cross-sectional telephone survey on caregivers of children suffering
from URCI.
First phase of the study incorporates medical data from Accident
& Emergency department (A&E) attendance records. The second
phase is a telephone-interview study, covering all traumatic injuries
classified as "domestic". Interview data were validated
by face-to-face interviews that covered the circumstances of the
injury event and co-residents demography. Coded injury descriptions,
based on the WHO's International Classification of External Causes
of Injury (ICECI), had be tested on inter-coder agreement as well
as respondents' test-retest reliability.
Setting and subjects
Children under the age of sixteen who visit the Accident &Emergency
Departments (A&E) for injury or poisoning were recruited for
the study. Injury profile of 18,919 intake records at three A&E
in Hong Kong were compiled from routine records. A subset of 5078
URCI was extracted from the larger dataset for further inquiry
by telephone interviews.
Major outcomes measures
Injured children were documented on their age, gender, external
causes, diagnoses, and location of injury. Additional variables
including severity of injury, parental practices, direct healthcare
utilization, and family demographics were documented for the URCI
subset.
Results
Children in the general injury profile were characterized with
an increased proportion of young children, male, and minor incidents
that required minimal medical attention. Injuries at home, school,
and recreation area accounted for approximately half of all injuries
cases compiles. Falls, struck by others, and motor vehicle related
injuries were the top three common external causes of injury.
Of moderate to mild severity, children injured at home were younger
than their non-home injury counterparts.
Implications to the filed
Results in present study have led to or substantiated two injury
prevention programs (i.e. Promoting a Safer Household Environment:
A Volunteer-based Home Visit Programme, and Injury Prevention
Programme in Schools), meanwhile, these will be used to compile
a profile of child injury as reported to the Accident & Emergency
departments (A&E) of hospitals in Hong Kong, which is currently
not available. The more in-depth details on the injury circumstances
and mechanisms surrounding such injuries at home will form the
basis for future studies focusing on the design of specific injury
prevention methods, and utilization of A&E / hospitalization
for childhood injury.
Publications
Chan, C. C., Cheng, J. C. Y., Wong, T. W., Chow,
C. B., Luis, B. P., Cheung, W. L., & Chan, K. (2000).
An international comparison of childhood injuries in Hong
Kong. Injury Prevention, 6(1), 20-23. |
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Chan, C. C., Chow, C. B., Cheng, J. C. Y., &
Chan, K. (2002, May 12-15, 2002).
Applying the PRECEDE-PROCEED framework to childhood injury
prevention in Hong Kong. Paper presented at the 6th World
Conference on Injury Prevention and Control, Montreal, Canada. |
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Chan, C. C., Luis, B. P., Chow, C. B., Cheng,
J. C. Y., Wong, T. W., Chan, K., & Tsui, S. (2001).
Validating narrative data on residential child injury.
Journal of Safety Research, 37(4), 377-389 |
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Chow, C., Chan, C. C., Cheng, J. C. Y., &
Chan, K. (2002, May 12-15, 2002).
Unintentional residential childhood injuries in Hong Kong.
Paper presented at the 6th World Conference on Injury Prevention
and Control, Montreal, Canada. |
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| Chan, C. C., Lui, P., Chow, C., Cheng, J., Wong,
T., & Chan, K. (2003). Unintentional Residential Child
Injury Surveillance in Hong Kong. Journal of Paediatrics and
Child Health, 39(6), 420-426. |
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Chow, C. B., Chan, C. C., Lui, P. K., Cheng,
J. C. Y., Wong, T. W. & Cheung, W. L. (1999, April 18-20,
1999).
A community-wide surveillance of childhood injury in Hong
Kong. Paper presented at the Hospital Authority Convention
1999, Hong Kong. |
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The Hong Kong Childhood Injury Prevention Research
Group (CIPRG). (1998).
Childhood injury prevention in Hong Kong. Hong Kong Medical
Journal, 4(4), 400-404. |
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Chan, K., Chan, C. C., & Lee, A. (May 12-15,
2002).
Cost of unintentional residential childhood injury morbidity
in Hong Kong. Paper presented at the 6th World Conference
on Injury Prevention and Control, Montreal, Canada. |
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Chan, C. C., Lui, P. K., Chow, C. B., Cheng,
J. C. Y., & Wong, T.W. (2001).
An Unintentional Child Injury Surveillance Study in Hong
Kong: Report submitted to the Health Services Research Committee,
Hong Kong. Hong Kong: The Hong Kong Childhood Injury Prevention
and Research Association (CIPRA). |
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Funding Sources
Health
Services Research Grant
Researchers
Dr. Charles C. Chan, the Principal Investigator, is an
Associate Professor at the APSS, HKPU; Convenor of the Network
for Health & Welfare Studies of the APSS, HKPU, and the Honorary
Secretary of CIPRA.
Mr. P. K. Luis is a Principal Lecturer at APSS, HKPU.
Dr. Chun Bong Chow is a Consultant Paediatrician at the
Department of Paediatrics, Princess Margaret Hospital, Hong Kong;
and Chairman of Hong Kong Childhood Injury Prevention and Research
Association (CIPRA).
Prof. Jack C. Y. Cheng is the Pro-Vice-Chancellors and
University Dean of Students, the Chinese University of Hong Kong;
Chair Professor at the Department of Orthopedics & Traumatology,
the Chinese University of Hong Kong and the Vice-chairman / Clinical
coordinator of CIPRA.
Prof. T. W. Wong is a Professor at the Department of Community
& Family Medicine, Chinese University of Hong Kong.
Mr. Kevin Chan is a Research Associate at the APSS, HKPU;
and Scientific Officer of CIPRA.
Contact
The Principal Investigator: Dr. Charles C. Chan
Tel: (852) 2766 7744
E-mail: sschchan@inet.polyu.edu.hk
Appendix
1.
Research and Policy August 2002
2.
Research and Professional Practice / Education January 2002
3.
Research and Professional Practice / Education August 2002
4.
Research and Professional Practice April 2002
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