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The Epidemiology of Injuries in Atlanta Day-care Centers

Jeffrey J. Sacks, MD, MPH; J. David Smith; Karen M. Kaplan, MD; Deborah A. Lambert, RN, MS; Richard W. Sattin, MD; R. Keith Sikes, DVM, MPH
JAMA. 1989;262(12):1641-1645. doi:10.1001/jama.1989.03430120095028.
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From June 1987 through May 1988, we collected reports of injuries among 5300 children who attended 71 day-care centers in Atlanta, Ga. One hundred forty-three injuries severe enough for the child to require medical or dental care were reported, including 63 lacerations (44.1%), 23 fractures (16.1%), 5 crush injuries (3.5%), 4 dislocations (2.8%), 2 human bites (1.4%), and 2 concussions (1.4%). The head was the site of 98 (68.5%) injuries. Peak hours for injuries were 11 AM and 4 PM, the peak day was Monday, and the peak season was summer. After adjustment for hours and dates of attendance, the rate was 1.77 injuries per 100 000 child-hours in day care; among preschool-aged children, infants had the lowest rate (0.77) and 2-year-old children had the highest rate (2.26). Almost 47% of injuries occurred on the playground; falls were involved in 70% of such injuries. Because 33% of all injuries resulted from falls on the playground, impact-absorbing playground surfaces may be a possible intervention to reduce injuries.

(JAMA. 1989;262:1641-1645)


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